Kansas City Collagenous Colitis Doctors

The diagnosis of collagenous colitis or lymphocytic colitis is made after tissue samples taken during colonoscopy or flexible sigmoidoscopy are examined under a microscope. Collagenous colitis is characterized by a larger-than-normal band of protein called collagen inside the lining of the colon. The thickness of the band varies, so multiple tissue samples from different areas of the colon may need to be examined. In lymphocytic colitis, tissue samples show inflammation with white blood cells known as lymphocytes between the cells that line the colon, and in contrast to collagenous colitis, there is no abnormality of the collagen.

People with collagenous colitis are most often diagnosed in their 50s, although some cases have been reported in adults younger than 45 years and in children aged 5 to 12. It is diagnosed more frequently in women than men.

People with lymphocytic colitis are also generally diagnosed in their 50s. Both men and women are equally affected.

Treatment for collagenous colitis and lymphocytic colitis varies depending on the symptoms and severity of the cases. The diseases have been known to resolve spontaneously, but most patients have recurrent symptoms. Lifestyle changes aimed at improving diarrhea are usually tried first.

Recommended changes include reducing the amount of fat in the diet, eliminating foods that contain caffeine or lactose, and not using NSAIDs. If lifestyle changes alone are not enough, medications are often used to control the symptoms of collagenous colitis and lymphocytic colitis.

• Antidiarrheal medications such as bismuth subsalicylate and bulking agents reduce diarrhea.
• Anti-inflammatory medications, such as mesalamine, sulfasalazine, and steroids including budesonide, reduce inflammation.
• Immunosuppressive agents, which reduce the autoimmune response, are rarely needed.

For very extreme cases of collagenous colitis and lymphocytic colitis, bypass of the colon or surgery to remove all or part of the colon has been done in a few patients. This is rarely recommended. Collagenous colitis and lymphocytic colitis do not increase the risk of colon cancer.