Presentation
Similar to adults, childhood CC has a female predilection and most present with diarrhea and abdominal pain, but atypical presentations (weight loss and constipation) can also be seen. [nature.com]
[…] only where adjacent crypts cut as cross-sections Present even when adjacent crypts are cut longitudinally Indistinct edges but no entrapped elements Jagged edges with entrapped capillaries and inflammatory cells Lacks chronic inflammatory infiltrate [surgpathcriteria.stanford.edu]
Common presentation is watery diarrhea without blood. Radiology and colonoscopy is normal. [ijpmonline.org]
Classically, patients present with chronic or intermittent watery diarrhea with or without abdominal pain, and usually without systemic symptoms 1. [jrheum.org]
We present a case of lansoprazole-associated collagenous colitis where the mucosa showed diffuse cloudiness mimicking ulcerative colitis. [wjgnet.com]
Entire Body System
- Pain
Successively, in July 2003 she developed an exacerbation of the low back pain. Pain woke her from sleep without relief despite rest and treatment with NSAIDs. Prior to this, she had been occasionally taking NSAIDs. [onlinelibrary.wiley.com]
Other symptoms of CC may include: Weight loss Belly pain Bloating Dehydration Nausea Fatigue or weakness Joint pain Not being able to control a bowel movement How is collagenous colitis diagnosed? You may need to see a gastroenterologist. [saintlukeskc.org]
Definition / general Disorder of chronic watery diarrhea and crampy abdominal pain with normal colonoscopy and barium enema; due to inflammation and patchy thickening of subepithelial basement membrane ( eMedicine: Collagenous and Lymphocytic Colitis [pathologyoutlines.com]
Side effects reported in the budesonide studies include nausea, vomiting, neck pain, abdominal pain, excessive sweating and headache. Side effects reported in the mesalamine studies included nausea and skin rash. [cochrane.org]
- Pathologist
Histopathological evaluation was performed blindly by the two pathologists. One pathologist measured the thickness of the collagen layer at 10 points at a magnification of 600 on a monitor screen. [gut.bmj.com]
It is of paramount importance that the clinician and the pathologist work as a well-integrated team; thus, the pathologist should receive accurate and detailed clinical information about the clinical problem ( Table I ), in addition to an adequate (at [scielo.isciii.es]
By considering the clinical history and symptoms, the pathologist should be able to reach the correct diagnosis in most cases.( 8 ) Good communication between the pathologist and clinician is therefore essential. [tropicalgastro.com]
Even if the bowel appears macroscopically normal on colonoscopy, multiple biopsies should be routinely taken for histopathology, and the pathologist informed of the possibility of microscopic colitis. [mja.com.au]
Because the gross appearance of the mucosa is most often normal, the diagnosis of microscopic colitis depends on the histological examination of colonic biopsy tissue by a pathologist. [massgeneral.org]
- Fatigue
Some patients report nocturnal diarrhea, abdominal pain, urgency, fecal incontinence, fatigue, dehydration and weight loss. [en.wikipedia.org]
Symptoms and Course of the Disease The clinical symptoms of microscopic (collagenous) colitis are characterized by watery diarrhea, possibly in conjunction with upper abdominal complaints, fatigue and bloating (meteorism). [drfalkpharma.com]
The most common symptoms include: chronic watery diarrhea abdominal pain abdominal cramps Other symptoms that can be less common include: dehydration weight loss bloating gas or flatulence nausea vomiting fatigue urgency to go to the bathroom incontinence [healthline.com]
Other symptoms include: abdominal pain (cramping or dull) weight loss fatigue (which may be caused by night-time diarrhea) fecal incontinence joint and muscle pain bloating and wind See our information sections on IBD and Fatigue, and Managing Bloating [ibdclinic.ca]
Fatigue and fever. Bleeding with watery diarrhoea. [medic8.com]
- Fever
Fatigue and fever. Bleeding with watery diarrhoea. [medic8.com]
The presence of fever or anemia is rare, and subcutaneous nodules are absent. [onlinelibrary.wiley.com]
"In addition to abdominal pain, low-grade fever also may be present. All of these symptoms, in addition to the person's age, should point to a diagnosis of ischemic colitis. [site.crohnscolitisfoundation.org]
None of them had blood stools, prolonged fever, and intestinal obstruction. The colonoscopic examination was normal in all of them. [tropicalgastro.com]
Patients will exhibit clinical symptoms (watery diarrhea, fever, nausea, abdominal pain or tenderness, loss of appetite) and test positive for the C diff organism or its toxin. [zgve.naturheilpraxis-geimer.de]
- Asymptomatic
It may be argued that this patient had asymptomatic microscopic colitis prior to dexlansoprazole exposure. [oatext.com]
Involvement of the axial skeleton with asymptomatic or clinical sacroiliitis is probably the most important hallmark; presence of concomitant inflammatory spinal pain is not uncommon, being in some cases the spinal disease clinically indistinguishable [onlinelibrary.wiley.com]
Zagorowicz et al. ( 52 ) found subtle physiological and histopathological differences between the bowel segments in chronic low-dose aspirin users but observed no specific MC features in asymptomatic individuals. [atm.amegroups.com]
Gastrointestinal
- Diarrhea
Cases Case 1 -- A 48-year-old woman presented with watery diarrhea. [oatext.com]
Diarrhea is secretory and has components of decreased sodium chloride absorption and active chloride secretion Severity of diarrhea correlates with inflammation, not thickness of collagen deposits ( Arch Pathol Lab Med 2010;134:1485 ) Children and adolescents [pathologyoutlines.com]
When chronic, however, diarrhea results in significant morbidity and may be symptomatic of a serious underlying disorder. [incytepathology.wordpress.com]
The following strategies are safe and may relieve diarrhea in some patients: Avoid NSAIDs and cigarettes Trial of lactose elimination (just to eliminate the possibility that intolerance to lactose in milk is aggravating the diarrhea) Anti-diarrhea agents [medicinenet.com]
We found that the patient had begun to take lansoprazole again 3 mo ahead of the recent diarrhea. Withdrawal of lansoprazole promptly resolved the diarrhea. [wjgnet.com]
- Abdominal Pain
Definition / general Disorder of chronic watery diarrhea and crampy abdominal pain with normal colonoscopy and barium enema; due to inflammation and patchy thickening of subepithelial basement membrane ( eMedicine: Collagenous and Lymphocytic Colitis [pathologyoutlines.com]
Symptoms are watery diarrhoea and abdominal pain. The cause of the disease is unknown. There is no cure, but the symptoms can be controlled by anti- inflammatory drugs. Stained with eosin and haematoxylin. [sciencephoto.com]
In our series, the most common symptoms were abdominal pain (4/5, 80%; Table 1 ). [nature.com]
Side effects in the prednisolone study included abdominal pain, headache, sleep disturbance, mood change and weight gain. [cochrane.org]
A 68 years old Syrian woman complaining for eight months history of recurrent episodes of watery diarrhea, associated with colicky abdominal pain. The diarrhea was intermittent or continuous for several months with remissions and relapses. [saudijgastro.com]
- Chronic Diarrhea
[…] of collagenous colitis in patients with chronic diarrhea who undergo a colonoscopy. [intechopen.com]
Idiopathic chronic inflammation of the colon (chronic colitis) is also an important differential consideration in the evaluation of chronic diarrhea. [incytepathology.wordpress.com]
Microscopic colitis in patients presenting with chronic diarrhea. Indian J Pathol Microbiol 2010;53:15-9 How to cite this URL: Misra V, Misra S P, Dwivedi M, Singh PA, Agarwal V. Microscopic colitis in patients presenting with chronic diarrhea. [ijpmonline.org]
It is a form of microscopic colitis, which causes chronic diarrhea. It typically occurs in middle-aged adults, is more common in females than in males, and has rarely been reported in children. [rarediseases.info.nih.gov]
Without these diagnostic steps, it could take weeks, months, or even years to discover the reason for the chronic diarrhea. [site.crohnscolitisfoundation.org]
- Nausea
Side effects reported in the budesonide studies include nausea, vomiting, neck pain, abdominal pain, excessive sweating and headache. Side effects reported in the mesalamine studies included nausea and skin rash. [cochrane.org]
The signs and symptoms of microscopic colitis may come and go regularly, and may include: Chronic watery diarrhea Fecal incontinence Nausea Pain or cramping in the abdomen Unintentional weight loss What are the causes of Pediatric Microscopic Colitis [childrens.com]
Symptoms Signs and symptoms of microscopic colitis include: Chronic watery diarrhea Abdominal pain or cramps Weight loss Nausea Fecal incontinence [alagappanherbalhospitals.com]
Other symptoms include: Always feeling like you need to have a bowel movement Weight loss Pain and cramping in the abdomen Fecal incontinence (leaking stool, caused by inability to control bowel movements) Nausea Dehydration (extreme thirst) Bile acid [my.clevelandclinic.org]
The most common symptoms include: chronic watery diarrhea abdominal pain abdominal cramps Other symptoms that can be less common include: dehydration weight loss bloating gas or flatulence nausea vomiting fatigue urgency to go to the bathroom incontinence [healthline.com]
- Rectal Bleeding
There is no associated abdominal pain, rectal bleeding or weight loss. She has a medical history of gastro-oesophageal reflux disease, depression and osteoarthritis and her medications include pantoprazole, sertraline and meloxicam. [hobsonhealthcare.com.au]
Its clinical presentation involves watery diarrhea in the absence of rectal bleeding. [en.wikipedia.org]
In rare cases there is also rectal bleeding. Diagnosis is through colonoscopy and mucosal biopsy where the subepithelial collagen table is distinctively thicker than normal. [medic8.com]
A year after the start of infliximab in 2014, she presented with an unintentional weight loss of more than 2 kg, fatigue, abdominal pain and chronic intermittent diarrhea with some rectal bleeding. [academic.oup.com]
During periods of symptom flare-ups, which often involve rectal bleeding, abdominal pain, fatigue and loss of fluids or nutrients, eating a normal diet becomes difficult. [zgve.naturheilpraxis-geimer.de]
Musculoskeletal
- Arthralgia
[…] enthesopathy Sacroiliitis and paramarginal syndesmophytes None Negative Positive No NSAID, SSZ Improved 34 M/58 3 Asymmetric polyarthritis Sacroiliitis, inflammatory spinal pain Psoriasis Negative Negative No NSAID, CS, SSZ Improved 35 F/48 2 Diffuse arthralgias [onlinelibrary.wiley.com]
Besides the relapses, patients in remission can still suffer from persisting symptoms such as abdominal pain, fatigue, arthralgia or myalgia several years after diagnosis ( 9 ). [atm.amegroups.com]
[…] disorders. 39, 40 Quality of life (QOL) was severely impaired in Swedish patients, particularly when the colitis is active compared to the background population. 41 A Swedish case-control study subsequently demonstrated that abdominal pain, fatigue, arthralgia [dovepress.com]
- Osteoporosis
[…] monitoring is not ensured, Known established cataract, Known hereditary problems of galactose or fructose intolerance, glucose-galactose malabsorption, sucrase-isomaltase insufficiency, Lapp lactase deficiency, or congenital lactase deficiency, Established osteoporosis [clinicaltrials.gov]
Oral corticosteroids like prednisone are useful for reducing inflammation, but they also carry some significant side effects -- like high blood pressure, osteoporosis, and diabetes -- that may outweigh their benefits. [site.crohnscolitisfoundation.org]
- Low Back Pain
In addition to the worsening of the low back pain, during the next weeks she developed an asymmetric oligoarthritis of the shoulders, right hip, and left knee. [onlinelibrary.wiley.com]
Workup
Extensive workup failed to identify an etiology for rectal prolapse other than CC in this case. However, it remains to be determined if CC is truly the cause of rectal prolapse in this case. [nature.com]
Colonoscopy
- Colitis
Expression Profiling of Inflammatory and Immunological Genes in Collagenous Colitis. 38 Liu Q...Harpaz N 31131860 2019 14 A case of spontaneous colonic perforation in collagenous colitis. 38 Mori H...Tani M 31152255 2019 15 Collagenous colitis diagnosed [malacards.org]
Definition Colorectal disease characterized by a thickened subepithelial collagen layer Alternate/Historical Names Microscopic colitis Used by some to refer to both lymphocytic and collagenous colitis, while to others it refers to only lymphocytic colitis [surgpathcriteria.stanford.edu]
Abstract Microscopic colitis, comprised of collagenous colitis and lymphocytic colitis, based on histopathologic findings, is a complex condition typically affecting elderly patients and rooted in genetic, environmental, and chemical exposures including [oatext.com]
Two similar but distinct entities comprise microscopic colitis – lymphocytic colitis and collagenous colitis. Lymphocytic Colitis. [incytepathology.wordpress.com]
Treatment
treatment has been established. [gut.bmj.com]
Radiological tests, such as a barium enema are also typically normal. [2] Treatment [ edit ] First line treatment for collagenous colitis is the use of budesonide, a steroid that works locally in the colon and is highly cleared by first pass effect. [en.wikipedia.org]
Treatment of collagenous colitis and lymphocytic colitis There is no cure, but treatment can manage the symptoms. [betterhealth.vic.gov.au]
In some cases, collagenous colitis disappears on its own without treatment. However, some people need treatment. Your treatment plan will depend on the severity of your symptoms. [healthline.com]
[…] with poorly understood origins, and whose best course for treatment is as equally vague. [badgut.org]
Prognosis
Prognosis. Overall, the prognosis for lymphocytic colitis and collagenous colitis is good. About 20% of patients undergo a spontaneous remission without specific therapy. [incytepathology.wordpress.com]
Little is known about the long term prognosis of the selected patient group with histological diagnosis of CC but without diarrhoea at diagnosis. [tandfonline.com]
Prognosis Approximately 20% of patients with microscopic colitis may have a spontaneous remission without specific therapy. [emedicine.medscape.com]
To conclude, the possibility of microscopic colitis should be considered while examining colonoscopic biopsy of a patient with chronic watery diarrhea and normal colonoscopy to avoid any misdiagnosis that may affect the treatment and prognosis of the [ijpmonline.org]
Long-term prognosis of clinical symptoms and health-related quality of life in microscopic colitis: a case-control study. Aliment Pharmacol Ther. 2014;39(9):963–972. 43. Capurso G, Marignani M, Attilia F, et al. [dovepress.com]
Etiology
etiology Diarrhea/pathology Female Humans Intestinal Mucosa/pathology Male Middle Aged Quality of Life [ncbi.nlm.nih.gov]
This condition is of unknown etiology and, in this case, appeared to respond to Stained sections from a rectal biopsy specimen showing the normal surface epithelium, the deposition of collagen as a band beneath the basement membrane, and the sparse chronic [jamanetwork.com]
[Crossref] Park T, Cave D, Marshall C (2015) Microscopic colitis: A review of etiology, treatment and refractory disease. World J Gastroenterol 21: 8804-8810. [oatext.com]
[…] lymphocytic colitis, but is clearly distinct from inflammatory bowel disease ( Gastroenterol Clin Biol 2008;32:689 ) Pseudomembranous collagenous colitis: morphologic variant in which active inflammation with pseudomembrane formation is prominent; various etiologies [pathologyoutlines.com]
"Microscopic colitis: A review of etiology, treatment and refractory disease". World Journal of Gastroenterology. 21 (29): 8804–8810. doi : 10.3748/wjg.v21.i29.8804. ISSN 1007-9327. PMC 4528022. [en.wikipedia.org]
Epidemiology
The epidemiology of microscopic colitis: a population based study in Olmsted County, Minnesota. Gut. 2007 ;56: 504 – 508. [tandfonline.com]
[…] inflammatory bowel disease ( Gastroenterol Clin Biol 2008;32:689 ) Pseudomembranous collagenous colitis: morphologic variant in which active inflammation with pseudomembrane formation is prominent; various etiologies ( Ann Diagn Pathol 2013;17:291 ) Epidemiology [pathologyoutlines.com]
The aim of this work was to analyse the epidemiological, clinical and therapeutic characteristics of this disease and its course. [link.springer.com]
Collagenous colitis in Orebro, Sweden, an epidemiological study 1984-1993. Gut. 1995;37:394-7. doi: https://doi.org/10.1136/gut.37.3.394. Tong J, Zheng Q, Zhang C, Lo R, Shen J, Ran Z. [revistagastrocol.com]
Pathophysiology
In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 7, 2018. Pardi DS, et al. [mayoclinic.org]
[…] morphologic variant in which active inflammation with pseudomembrane formation is prominent; various etiologies ( Ann Diagn Pathol 2013;17:291 ) Epidemiology 85% in elderly women, often smokers Most cases in Western countries, rare in Asia or Africa Pathophysiology [pathologyoutlines.com]
The aetiology and pathophysiology remain unclear. Conditions associated with it include autoimmune diseases. There may be a genetic predisposition, as familial cases have been described. [ncbi.nlm.nih.gov]
Effective strategies to prevent and treat AD remain elusive despite major efforts to understand its basic biology and clinical pathophysiology. Significant investments in therapeutic ... [annualreviews.org]
31131860 2019 14 A case of spontaneous colonic perforation in collagenous colitis. 38 Mori H...Tani M 31152255 2019 15 Collagenous colitis diagnosed by endoscopically induced mucosal tears. 38 Shiratori Y...Fukuda K 31110073 2019 16 Microscopic colitis: pathophysiology [malacards.org]
Prevention
Prevention of Collagenous and Lymphocytic Colitis With the current causes being idiopathic or microscopic, preventions are harder to identify. [medic8.com]
There are no current recommendations for preventing collagenous colitis. However, following diet and medication changes recommended by your doctor may reduce the likelihood of having a relapse. [healthline.com]
Effective strategies to prevent and treat AD remain elusive despite major efforts to understand its basic biology and clinical pathophysiology. Significant investments in therapeutic ... [annualreviews.org]
It's caused by problems in the blood vessels that, in turn, prevent the bowel from getting enough blood. [site.crohnscolitisfoundation.org]
In patients with recurrent disease, MC recurrence prevention is desirable. The recommended primary treatment of MC is with the glucocorticoid budesonide ( 9, 14 ). [atm.amegroups.com]