Collagenous colitis / Lymphocytic colitis
Sutter Davis Hospital Gastroenterology

Definition
Collagenous colitis and lymphocytic colitis are inflammatory conditions of the colon that cause chronic, non-bloody, watery diarrhea. Some researchers believe that collagenous colitis and lymphocytic colitis are different phases of the same condition rather than separate conditions.

Causes
The cause of collagenous colitis and lymphocytic colitis is unknown. Some researchers believe that bacterium and the toxins they produce or a virus may trigger the inflammation associated with these conditions. There have been some reports of collagenous colitis and lymphocytic colitis occurring in families, suggesting a possible genetic component in some cases.

Symptoms
Collagenous colitis and lymphocytic colitis can affect different parts of the colon. In some people, the inflammation tends to occur in patches along the lining of the colon. In other people, it's present along the entire length of the bowel.  Signs and symptoms include:

• Chronic diarrhea
• Abdominal pain or cramps
• Abdominal bloating (distention)
• Modest weight loss
• Nausea
• Fecal incontinence
• Dehydration

People with collagenous colitis or lymphocytic colitis often have one or more additional autoimmune disorders as well, such as:

• Celiac disease, a digestive system disorder associated with the intake of the protein gluten, which may have the same signs and symptoms as microscopic colitis
• Diabetes mellitus
• Thyroid disorders
• Pernicious anemia, a condition that results in low red blood cell counts
• Scleroderma, a disease of the skin and connective tissue
• Sjogren's syndrome, an immune system dysfunction causing inflammation of the connective tissue
• CREST syndrome, a connective tissue disorder affecting the skin and blood vessels

Treatment

• Lifestyle changes: As a first step, you'll need to make adjustments to your diet. By decreasing the amount of fat you consume, your signs and symptoms may ease. Also, remove caffeine from your diet as well as foods containing lactose (milk sugar found in dairy products). Avoid spicy foods and alcohol.
• Medications: If problems persist despite adjustments in lifestyle, the next step is to take medications. Before your doctor recommends medications, however, he or she will want to exclude other possible causes for your symptoms, such as celiac disease.
• Surgery: When the symptoms of collagenous colitis and lymphocytic colitis are severe, and medications aren't effective, your doctor may recommend surgery to remove inflamed portions of your colon, which tends to eliminate diarrhea. Surgery is rare for these conditions.