Collagenous or microscopic colitis is diagnosed and treated by the GI Division of Premier Medical Group.
Collagenous or microscopic colitis is diagnosed and treated by the GI Division of Premier Medical Group.
Collagenous is an inflammation of the bowel that is only visible using a microscope (microscopic colitis). It is a rare digestive disorder that affects the colon and rectum, predominantly affects females, and presents most often in people over 45. Collagenous is a type of IBD, or inflammatory bowel disease, which occurs when there is an excessive build-up of white blood cells in the bowel lining causing inflammation in the bowel.
This type of colitis is less severe than other types of IBD because it does not lead to cancer and seldom requires surgery. However, microscopic colitis can cause substantial pain and discomfort. Microscopic colitis affects the colon and rectum.
The exact causes of collagenous colitis are unknown, but scientific evidence suggests immunological, environmental, and genetic factors as potential causes of the disorder. Some researchers believe collagenous colitis is a kind of autoimmune response, prompted by something in the GI tract. The immune system can react to harmless bacteria, pollen, food or even your own body’s cells. When the GI tract is kept empty for a period of time, the inflammation seems to subside, but when food is re-introduced and digestive activity occurs, the inflammation returns. To arrange this would require a surgical procedure called an ileostomy, which diverts digestive waste through an opening in the stomach.
Other theories for the cause(s) of collagenous colitis are:
The main symptom of collagenous colitis is chronic watery and non-bloody diarrhea, which can last for weeks, months, or even years. There can be a break in the episodes of diarrhea. It is believed that this type of diarrhea is brought on by the inability of the intestinal tract to absorb electrolytes (salts and minerals). This causes an imbalance and decreases the colon’s ability to absorb fluid, thus resulting in diarrhea.
Other common symptoms of microscopic colitis include:
The only way to get an accurate microscopic colitis diagnosis is by examining intestinal tissue removed during colonoscopy or flexible sigmoidoscopy. Your doctor will also take a complete physical and medical history to be certain there are no other conditions present that could be causing the diarrhea. He or she will also ask you to provide a stool specimen to check for blood and/or infection. A blood test helps diagnose microscopic colitis by eliminating any other possible infections.
During the colonoscopy, your doctor will be able to rule out any other conditions by looking at the colon. Again, to be certain of a microscopic colitis diagnosis, the doctor will need to remove small pieces of tissue and send to the lab for testing. This is called a biopsy, and a pathologist (a doctor trained to diagnose diseases based on tissue appearance) examines the tissue with a microscope.
There are two types of microscopic colitis: collagenous colitis and lymphocytic colitis. With collagenous, the layer of collagen beneath the epithelium appears thicker than normal, which may result from inflammation. In both types, there is an increase in white blood cells in the intestinal lining. The symptoms and treatment for lymphocytic and collagenous colitis are identical.
The treatment for microscopic colitis begins with the alleviation of certain medications and foods. Antidiarrheal medications may be effective for some patients.
Your doctor may recommend:
While many people find relief from the symptoms of microscopic colitis by stopping certain medications and/or taking different medications that target the colitis. For chronic problems and to prevent future symptoms, there are also plenty of dietary changes you can explore.
The best diet for microscopic colitis can mean different things to different people. Many of these changes can provide some measure of relief; some may not make any difference for you. Ideally, you won’t to adopt every single recommendation to alleviate the symptoms of microscopic colitis.
There are lifestyle changes you can make, such as:
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