ABSTRACT
AIM: To study the clinical characteristics, treatment response and evolution in patients with microscopic colitis. MATERIAL AND METHODS: We performed a retrospective analysis of 24 patients (15 with collagenous colitis and 9 with lymphocytic colitis). Clinical and diagnostic features, treatment response and evolution according to the presence of maintenance therapy were evaluated. RESULTS: The mean age of the patients was 59.7 years and most were male. Nine patients took non-steroidal anti-inflammatory drugs (NSAID). No significant association was found with other drugs. Four patients presented associated rheumatological disease. Most patients presented insidious-onset diarrhea without pathological products, which was frequently associated with other symptoms (abdominal pain, bloating, weight loss, asthenia, tenesmus, and incontinence). Seven patients showed a slight increase in globular sedimentation rate. Fat in stools and radiological investigations (transit and opaque enema) were normal in patients who underwent these tests. Endoscopy revealed non-specific alterations in 42% of the patients while results were normal in the remaining patients. One patient showed clinical improvement on withdrawal of NSAIDs and 4 patients improved spontaneously. Clinical response was achieved in 7 of 13 patients treated with antimotility drugs, in 8 of 9 patients treated with salicylates, in 3 treated with oral corticoids, in 1 treated with cholestyramine and in 1 treated with topical budesonide. Nineteen patients required no maintenance therapy, 4 were administered salicylates and 1 was administered cholestyramine. After a mean follow-up of 42 months, evolution was chronic and intermittent in 14 patients and chronic and continuous in 1; 9 patients presented a single episode. No significant differences were found between patients administered maintenance therapy and those who were not or between collagenous colitis and lymphocytic colitis in the parameters analyzed. CONCLUSIONS: Microscopic colitis constitutes a group of diseases characterized by chronic diarrhea, few systemic effects and minimal radiological and/or endoscopic alterations. Evolution is characterized by recurrent episodes, with good response to treatment with cholestyramine, salicylates or corticoids when required.
Subject(s)
Colitis/therapy , Adult , Aged , Aged, 80 and over , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Arthritis/complications , Colitis/complications , Colitis/pathology , Collagen Diseases/complications , Collagen Diseases/pathology , Collagen Diseases/therapy , Diarrhea/etiology , Female , Follow-Up Studies , Humans , Lymphocytes , Male , Middle Aged , Retrospective StudiesABSTRACT
La colitis colágena es una enfermedad cuya frecuencia ha aumentado progresivamente en los últimos años debido fundamentalmente a la toma rutinaria de biopsias en el estudio de pacientes con diarrea crónica. Se han comunicado buenas respuestas con numerosos tratamientos, aunque hay pocos ensayos clínicos realizados por el escaso número de pacientes con esta patología. Presentamos dos casos de colitis colágena cuyo interés reside en su manejo terapéutico, revisando las distintas alternativas existentes en el tratamiento de esta entidad de creciente importancia en la práctica clínica diaria (AU)
Subject(s)
Adult , Aged , Male , Female , Humans , Budesonide , Anti-Inflammatory Agents, Non-Steroidal , Anti-Inflammatory Agents , Collagen Diseases , Colitis , Diarrhea , Administration, Topical , Enema , GlucocorticoidsABSTRACT
Collagenous colitis is a disorder which has been diagnosed with increasing frequency in the last few years, probably due to the routine obtention of colon biopsy specimens in the study of patients with chronic diarrhoea. Good responses have been reported with a number of therapies, although only a scarce number of clinical trials have been performed, partly because of the small number of patients studied. Two cases of collagenous colitis with different therapeutic approaches are here reported. All medical therapy options for this interesting disorder are reviewed.