Collagenous Colitis and Lymphocytic Colitis FAQs
Q: How are Collagenous Colitis and Lymphocytic Colitis different from Crohn's disease and Ulcerative Colitis?
A: The general term for diseases that cause inflammation in the intestines is Inflammatory Bowel Disease. Crohn's disease and Ulcerative Colitis are the inflammatory bowel diseases that are most commonly known. However, Collagenous Colitis and lymphocytic colitis are two other types of bowel inflammation that affect the colon. Collagenous Colitis and Lymphocytic Colitis are less severe forms of Inflammatory Bowel Disease compared to Crohn's disease or Ulcerative Colitis.
Also known as microscopic colitis, Collagenous Colitis and Lymphocytic Colitis, show no sign of inflammation on the surface of the colon during a colonoscopy or flexible sigmoidoscopy, two tests that allow a doctor to view the inside of your large intestine. A biopsy is required to make a diagnosis due to the slight visibility of the inflammation. The biopsy involves removing a small piece of tissue from the lining of the intestine during a colonoscopy or flexible sigmoidoscopy.
Q: What are the symptoms of Collagenous Colitis and Lymphocytic Colitis?
A: Collagenous Colitis and Lymphocytic Colitis have the same symptoms-chronic, non-bloody, and watery diarrhea. There may also be abdominal pain or cramps. Some individuals who have Collagenous Colitis and Lymphocytic Colitis may suffer from constant diarrhea while others will have moments of being symptom-free.
Q: What are the causes of Collagenous Colitis and Lymphocytic Colitis?
A: Currently, scientists do not know the exact causes of Collagenous Colitis or Lymphocytic Colitis. Bacteria or a virus may be responsible for the inflammation and damage to the colon. Some scientists believe that Collagenous Colitis and Lymphocytic Colitis derive from an autoimmune response, which means that the body's immune system destroys healthy cells for unknown reason.
Q: Who gets Collagenous Colitis and Lymphocytic Colitis?
A: Collagenous Colitis is most often diagnosed in people 60 to 80 years old. However, there have been diagnosis in children and in adults younger than 45 years old. Collagenous Colitis is diagnosed more often in women than men.
People with Lymphocytic Colitis are also most diagnosed on those between 60 and 80 years of age. Lympohcytic Colitis is equally diagnosed between men and women.
Q: How are Collagenous Colitis and Lymphocytics Colitis diagnosed?
A: Some scientists think that Collagenous Colitis and Lymphocytic Colitis are part of the same disease, but in different stages. Performing a biopsy is the only way to determine which form of the colitis disease an individual has.
Collagenous Colitis shows an irregularly large band of protein, known as collagen, inside the lining of the colon. The bands vary in thickness; so tissue samples from multiple areas of the colon may need to be examined.
With Lymphocytic Colitis, tissue samples are characterized by an increase of white blood cells, known as lymphocytes, between the cells lining the colon. The collagen is not affected.
Q: What are the types of treatment?
A: Based on the severity and symptoms of the case, treatment for Collagenous Colitis and Lymphocytic Colitis varies. Although many suffer from ongoing or occasional diarrhea, there have been many cases where the two diseases have resolved themselves.
Normally, lifestyle changes are implemented as treatment first. Some recommendations include decreasing fat intake, removing foods that contain caffeine and lactose, and steering clear from over-the-counter pain relievers (e.g. ibuprofen, aspirin, etc.).
If a lifestyle change is not effective, medications can help control symptoms.
A medical treatment often begins with prescribing anti-inflammatory medications, such as mesalamine (Rowasa or Canasa) and sulfasalazine (Azulfidine), to reduce swelling.
Steroids, including budesonide (Entocort) and prednisone, are used to reduce inflammation as well. However, steroids are normally only used to control sudden diarrhea. Long-term use of steroids is not recommended due to side effects such as bone loss and high blood pressure.
Anti-diarrheal medications such as bismuth subsalicylate (Pepto Bismol), diphenoxylate atropine (Lomotil), and loperamide (Imodium) may provide short-term relief.
Immunosuppressive agents, such as azathioprine (Imuran), reduce the inflammation but are rarely needed.
For severe cases of Collagenous Colitis and Lymphocytic Colitis that have not responded to medication, surgery may be required to remove all or part of the colon. However, the surgical method is rarely recommended.
Collagenous Colitis and Lymphocytic Colitis do not increase a person's risk of getting colon cancer.
Source: NIH Publication No. 06-5036, Collagenous Colitis and Lymphocytic Colitis, January 2006