About colitis, collagenous
What is colitis, collagenous?
Collagenous colitis is a rare digestive disorder that primarily affects females and typically becomes apparent during middle age. The disorder is characterized by inflammatory changes of the mucous membranes (mucosa) of the colon (colitis) and abnormal accumulation (excessive deposition) of the protein collagen beneath the surface (epithelial) layer of the mucosa (thickened subepithelial collagenous bands). The colon is the major portion of the large intestine. The medical literature often refers to collagenous colitis as a form of "microscopic colitis," since evidence of inflammation and other abnormalities may only be confirmed through microscopic (i.e., histologic) examination of multiple tissue samples.
Individuals with collagenous colitis typically experience episodes of chronic, watery, nonbloody diarrhea. In some instances, episodes may often occur at night (nocturnal diarrhea). Diarrheal episodes may be persistent or may occur at intervals (intermittent) over a period of weeks, months, or years. Other symptoms and findings that may occasionally be associated with such episodes include vague abdominal pain, abdominal swelling (distension), nausea, vomiting, and/or weight loss.
The exact cause of collagenous colitis is unknown. Possible immunological, environmental, genetic, and/or other factors are under investigation as potential causes of the disorder.
What are the symptoms for colitis, collagenous?
The symptoms of collagenous colitis can come and go, and vary in severity.
The most common symptoms include:
- chronic watery Diarrhea, which can appear and disappear over a period of weeks, months, or years
- Abdominal pain
- Abdominal cramps
Less common symptoms include:
- Weight loss
- flatulence or gas
- an urgent need to go to the bathroom
- fecal incontinence
What are the causes for colitis, collagenous?
Like many other gastrointestinal conditions, the exact cause of collagenous colitis is unknown. Research indicates that it likely has a genetic basis and could be related to autoimmune conditions.
Some possible causes of collagenous colitis include:
- genetic abnormalities
- autoimmune conditions such as rheumatoid arthritis, psoriasis, and Crohn’s disease
- certain bacteria or viruses
Collagenous colitis isn’t contagious. It can’t spread to other people.
Medications as triggers
Medications that may trigger microscopic colitis and collagenous colitis include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed class of antidepressants
- angiotensin-converting enzyme (ACE) inhibitors for high blood pressure
- angiotensin II receptor blockers (ARBs) for high blood pressure, heart disease, or kidney disease
Research is mixed on the effects of the following medications:
- statins for high cholesterol
- protein pump inhibitors (PPIs) and H2 receptor blockers, which are used to treat acid reflux and GERD
- oral medications for diabetes
Some research states that they have little to no effect on microscopic colitis, or may even be associated with lower rates of the condition.
Other studies indicate that these medications also trigger microscopic colitis and collagenous colitis.
According to a 2021 study, if these medications are associated with increased rates of microscopic colitis and collagenous colitis, it may be because they make diarrhea worse. A worsening case of diarrhea then prompts a doctor to make a diagnosis of colitis.
What are the treatments for colitis, collagenous?
In some cases, collagenous colitis disappears on its own. However, some people need treatment.
Your treatment plan will depend on the severity of your symptoms.
Diet and lifestyle changes
Your doctor may recommend diet and lifestyle changes to help treat this condition. These changes are usually the first part of any treatment plan.
Common diet changes include:
- eating a reduced fat diet
- opting for a gluten-free diet
- drinking more fluids to prevent dehydration from diarrhea
- switching to a milk-free diet
- avoiding food with artificial sweeteners
- eliminating caffeine and lactose
Common lifestyle changes include:
- quitting smoking, if you smoke
- maintaining a moderate weight
- maintaining a healthy blood pressure
- exercising regularly
Your doctor will review the medications you currently take and make suggestions about either continuing or stopping them.
In 2016, the American Gastroenterological Association (AGA) released its guidelines on microscopic colitis. The AGA recommends starting with budesonide, a type of corticosteroid, before considering other medications.
Other medications your doctor may recommend to help treat the symptoms of collagenous colitis include:
- antidiarrheal medications
- intestinal anti-inflammatory medications, such as mesalamine (Apriso, Asacaol HD, Pentasa) or sulfasalazine (Azulfidine)
- medications that block bile acids, such as cholestyramine (Prevalite)
The supplement psyllium may be recommended, too. Immunomodulators or anti-TNF (tumor necrosis factor) therapies may be used in extreme cases.
The Food and Drug Administration (FDA) hasn’t approved any medications for microscopic colitis or collagenous colitis. However, medications such as mesalamine and sulfasalazine are FDA approved for the treatment of ulcerative colitis.
If a doctor prescribes medications such as these for collagenous colitis, it’s considered an example of off-label drug use.
OFF-LABEL DRUG USE
Off-label drug use means a drug that’s approved by the FDA for one purpose is used for a different purpose that hasn’t yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.
Your doctor may recommend surgery if diet and medication changes don’t help. Surgery is usually reserved for extreme cases. It’s not a typical treatment for collagenous colitis.
The most common types of surgery for collagenous colitis include:
- colectomy, which means removing all or part of the colon
- ileostomy, which means creating an opening in the abdomen after a colectomy
What are the risk factors for colitis, collagenous?
most susceptible in:
- ages 50-70,
- have celiac disease,
- thyroid problems, etc,
Is there a cure/medications for colitis, collagenous?
Collagenous colitis is one type of microscopic colitis. These particular white blood cells can enter the inner wall of the colon as a result of inflammation. This particular type of colitis is uncommon and may be caused by an autoimmune disorder.
Cure or medication for Collagenous colitis
- Collagenous colitis might heal on its own. However, you might require treatment to get better if your symptoms are severe or persistent.
- Typically, medical professionals employ a sequential process, beginning with the most basic, endurable treatments.
- Depending on your symptoms and how severe they are, your treatment may change.
- They include everything from dietary and lifestyle adjustments to OTC and prescription drugs.
- Some patients experience recurrent symptoms that eventually go away on their own.
- Some people can effectively control their symptoms by making dietary modifications alone, while others might require occasional or more frequent pharmaceutical use.
- There is no specific diet for collagenous colitis, but it can manage the symptoms with diet by avoiding things that make them worse and consuming more anti-inflammatory foods.
- However, the trigger foods will be unique to you, so finding them may need some trial and error.
Dehydration,Nausea and vomiting,Weight loss,Muscle cramps or muscle pain,Joint pain and stiffness,Headaches or migraines,Mouth sores,Skin rashes,Acid reflux,Swollen lymph nodes,Thyroid problems
Bulking agents,Anti-diarreheals,Bismuth Subsalicylate,Mesalamine,Bile acid sequestrants
Abdominal pain and cramping,Abdominal distension and bloating,Urgency to poop and trouble holding poop in,Noisy digestive system,Gluten sensitivity,Fatigue