title: Collagenous colitis in Spain: a report of nine new cases.
abstract: BACKGROUND
  collagenous colitis is a clinicopathological entity that causes chronic watery diarrhea. The patients are predominantly women in the sixth or seventh decade of life. Radiological and endoscopic studies are usually normal or nonspecific. It is diagnosed by the presence in colonic biopsies of a thickened subepithelial band of collagen and an inflammatory infiltrate in the mucosa.
  
  
  METHODS
  9 cases diagnosed in our hospital and 18 previously described in Spain have been reviewed.
  
  
  RESULTS
  all the cases showed chronic watery diarrhea. In 17 patients symptoms were present since at least one year before diagnosis. Five of the 27 patients had been taking nonsteroidal antiinflammatory drugs. Rheumatological and autoimmune diseases were found in 6 patients. Colonoscopy was normal or showed nonspecific findings except in one of our patients, in which aphthous ulcers and pseudomembranes were found. Different treatments had been employed, including antidiarrheal agents, sulfasalazine, 5-ASA and omeprazole.
  
  
  CONCLUSIONS
  collagenous colitis is uncommon but should be considered in patients with long-standing chronic watery, nonbloody diarrhea. Collagenous colitis is probably more common than we think, as biopsies are not usually taken in cases of chronic diarrhea with normal endoscopic findings.
authors.affiliation: Servicio de Gastroenterología, Hospital Ramón y Cajal,Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Bermejo
authors.forename: V
authors.initials: V
authors.lastname: Moreira
authors.forename: C
authors.initials: C
authors.lastname: Redondo
authors.forename: M A
authors.initials: MA
authors.lastname: Martín Scapa
authors.forename: J P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: V
authors.initials: V
authors.lastname: Defarges
authors.forename: R
authors.initials: R
authors.lastname: Aller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003092:Colitis / Q000175:diagnosis* / Q000188:drug therapy; D003094:Collagen; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013030:Spain
chemical_list: D003094:Collagen