Collagenous colitis refers to an inflammatory disease of the colon, which is associated with chronic and watery diarrhea, without blood. The condition normally affects adults in the fifth decade of their life is has a higher prevalence in females compared to males.
However recent population based studies have indicated the incidence of the disease in younger populations including children. The condition is also referred to as Lymphocytic Colitis.
The incidence of the Collagenous Colitis is high among industrialized nations namely United States, Australia, New Zealand, Canada and Europe. Estimates are suggestive of an incidence has increased from one per 100000 population to 19.6 per 100000 over the past three decades. The prevalence of the condition increases with age and is highest in the seventh decade of life. Though the condition is not life threatening, there are incidences in which intensive resuscitation is required especially in cases associated with excessive dehydration, weight loss and vitamin deficiency.
Collagenous Colitis: An Overview
The colon wall comprises of five circular layers with the innermost layer referred to as the mucosa or the epithelium of the colon. The characteristic feature of Collagenous Colitis is the presence of infiltration of lymphocytes in this region which results in the thickening of the sub epithelial collagen network. The excessive diarrhea is attributed to the inflammatory process and it is considered that the thickened sub epithelial layer can interfere with the diffusion and absorption of water. Further increased levels of prostaglandin E2 also contribute to watery diarrhea. Invariably in most cases, the condition is associated with a normal and healthy colon mucusa, as detected by radiography or endoscopy.
Though, the infiltration is usually limited to the colon, in some patients infiltration can be observed even in the ileum and duodenum of the small intestine. Often the condition is also presented in the form of bile acid malabsorption.
Collagenous Colitis Treatment
Despite the fact that, several multiple treatment options for the management of Collagenous Colitis are available, no single treatment is considered effective. The medical community has been unable to understand and cure the condition effectively. The overall prognosis of the condition varies from individual to individual. It should be noted that the condition is not fatal but can be very debilitating and distressing.
Clinical experience has indicated that there have been incidences of complete disappearance of symptoms without relapse; however in general, the symptoms tend to resurface after a particular period of time. The condition is often associated with other celiac disease but has not been related to colorectal cancer.