title: Clinical course of microscopic colitis in a single-center cohort study.
abstract: OBJECTIVE
  The long-term natural history of collagenous (CC) and lymphocytic colitis (LC) is not well known. The aims of this study were to evaluate the clinical course of microscopic colitis (MC) and to describe the morbidity evolution of the disease.
  
  
  METHODS
  This study is based on a cohort of 54 patients (35 LC/19 CC), previously included in a randomized trial treated with mesalazine with or without cholestyramine. Patients were followed-up closely during the subsequent 5 years, undergoing clinical, endoscopic and histologic evaluation at least yearly. After this period, they were encouraged to undergo periodical clinical evaluations.
  
  
  RESULTS
  In a mean follow-up time of 104.9 ± 14.1 months (range 81-138 months) at the end of the therapy, 12 patients (7 LC and 5 CC) relapsed. Of these patients, 4 reported a mild clinical relapse self-treated with antidiarrheal medication. In total 49 patients are clinically free from diarrhea, to date. At multivariate analysis the only predictive factor of relapse seems to be a slow response to treatment.
  
  
  CONCLUSIONS
  Only a minority of patients with MC had diarrhea more than once a week in a long-term follow-up and the symptom pattern was similar between CC and LC patients.
authors.affiliation: Department of Clinical Medicine, University of Bologna, Italy. carlo.calabrese2@unibo.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Calabrese
authors.forename: Paolo
authors.initials: P
authors.lastname: Gionchetti
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Liguori
authors.forename: Alessandra
authors.initials: A
authors.lastname: Areni
authors.forename: Giulia Spuri
authors.initials: GS
authors.lastname: Fornarini
authors.forename: Massimo
authors.initials: M
authors.lastname: Campieri
authors.forename: Fernando
authors.initials: F
authors.lastname: Rizzello
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D002792:Cholestyramine Resin / Q000627:therapeutic use; D015331:Cohort Studies; D046729:Colitis, Collagenous / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D046730:Colitis, Lymphocytic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D003967:Diarrhea / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D015999:Multivariate Analysis; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000924:Anticholesteremic Agents; D002792:Cholestyramine Resin; D019804:Mesalamine