Synonyms
Chronic watery diarrhea; Microscopic colitis
Definition
Collagenous colitis (CC) is defined as a chronic nondistorting colitis with the deposition of characteristic thick collagen band immediately beneath the surface epithelium. This layer has an irregular, jagged lower edge and consists of collagen fibers, inflammatory cells, and capillaries. The average collagen width has been reported as 10–20 μm, compared with the normal basement membrane width of up to 3 μm. Patients with CC generally suffer from chronic watery diarrhea. Colonoscopy is usually normal or near normal.
Clinical Features
Incidence
The reported incidence is between 1 and 2 in 100,000.
Age
Primarily affects middle-aged or older adults.
Sex
There is slight female predominance over males as 1.8:1.
Site
CC involves the entire colon in a patchy fashion. In some cases there may be rectal or left colonic sparing.
Treatment
Most patients with CC require anti-inflammatory therapy with either steroids or 5-ASA compounds.
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References and Further Reading
Fernández-Bañares, F., Salas, A., Esteve, M., et al. (2003). Collagenous and lympho-cytic colitis: Evaluation of clinical and histological features, response to treatment, and long-term follow-up. The American Journal of Gastroenterology, 98, 340–347.
Lazenby, A. J., Yardley, J. H., Giardiello, F. M., et al. (1990). Pitfalls in the diagnosis of collagenous colitis: Experience with 75 cases from a registry of collagenous colitis at the Johns Hopkins Hospital. Human Pathology, 21, 905–910.
Lindstrom, C. G. (1976). ‘Collagenous colitis’ with watery diarrhoea: A new entity? Pathologia Europaea, 11, 87–89.
Widgren, S., Jlidi, R., & Cox, J. N. (1988). Collagenous colitis: Histologic morphometric immunohistochemical and ultrastructural studies. Report of 21 cases. VirchowsArchiv Anatomy, 413, 287–296.
Yuan, S., Reyes, V., & Bronner, M. P. (2003). Pseudomembranous collagenous colitis. The American Journal of Surgical Pathology, 27, 1375–1379.
Langner C, Aust D, Ensari A, Villanacci V, Becheanu G, Miehlke S, Geboes K, Münch A. (2015). Working Group of Digestive Diseases of the European Society of Pathology (ESP) and the European Microscopic Colitis Group (EMCG). Histology of microscopic colitis-review with a practical approach for pathologists. Histopathology, 66(5), 613–626.
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Ensari, A. (2017). Collagenous Colitis. In: Carneiro, F., Chaves, P., Ensari, A. (eds) Pathology of the Gastrointestinal Tract. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-40560-5_1435
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DOI: https://doi.org/10.1007/978-3-319-40560-5_1435
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