Department of Inflammation Medicine, Division of Gastroenterology, Institution of Clinical and Experimental Medicine (IKE), Linköping University, Linköping, Sweden.
Neurogastroenterol Motil. 2010 May;22(5):534-8, e118. doi: 10.1111/j.1365-2982.2010.01472.x. Epub 2010 Feb 12.
Collagenous colitis (CC) is characterized by chronic watery diarrhea, a macroscopically normal colonic mucosa but typical microscopic inflammation. Chronic mucosal inflammation of the colon and rectum has earlier been associated with altered visceral sensitivity, but anorectal function has never been reported in cases of CC.
Fifteen patients with CC in active phase recorded their symptoms. The severity of inflammation was determined in mucosal biopsies. Anorectal function was assessed and compared with that of 15 healthy volunteers of corresponding age and matched for gender. After 6 weeks of budesonide treatment when the patients were in clinical remission anorectal function was re-assessed.
All patients had inflammation also in rectum. Patients in active phase had, during rectal balloon distension a higher rectal sensory threshold for the feeling of first sensation, compared with controls (P = 0.02). There were no differences in rectal sensory threshold for the feeling of urgency or maximum distension, between patients with CC in active phase and healthy controls. Rectal volume at first sensation was significantly greater in patients than in controls (P = 0.02), but there were no differences at urgency or maximum distension. Twelve of 15 patients completed 6 weeks of budesonide treatment and all went into clinical remission. No differences in anorectal function were measured when patients had active disease, compared with clinical remission.
CONCLUSIONS & INFERENCES: Collagenous colitis was not associated with rectal hypersensitivity or disturbed anal function despite rectal inflammation. On the contrary, the sensation threshold for light rectal pressure was elevated in patients with active CC.
胶原性结肠炎（CC）的特征为慢性水样腹泻、肉眼正常的结肠黏膜但存在典型的显微镜下炎症。结肠和直肠的慢性黏膜炎症先前与内脏敏感性改变有关，但 CC 病例的肛门直肠功能从未被报道过。
15 例处于活动期的 CC 患者记录其症状。在黏膜活检中确定炎症的严重程度。评估肛门直肠功能，并与相应年龄和性别匹配的 15 名健康志愿者进行比较。在患者处于临床缓解期的 6 周时，重新评估肛门直肠功能。
所有患者的直肠均有炎症。与对照组相比，活动期患者在直肠球囊扩张时，对初次感觉的直肠感觉阈值更高（P = 0.02）。活动期 CC 患者与健康对照组之间，在急迫感或最大扩张时的直肠感觉阈值方面无差异。初次感觉时，患者的直肠容量明显大于对照组（P = 0.02），但在急迫感或最大扩张时无差异。15 例患者中的 12 例完成了 6 周的布地奈德治疗，所有患者均进入临床缓解期。在疾病活动期和临床缓解期，患者的肛门直肠功能均无差异。
尽管存在直肠炎症，但胶原性结肠炎与直肠高敏性或肛门功能障碍无关。相反，活动期 CC 患者的直肠轻压感觉阈值升高。
