Subepithelial collagen thickening in the colon: report on a series of 23 patients.

BACKGROUND

To investigate the prevalence of collagenous colitis in patients presenting with diarrhoea.

METHODS

Descriptive retrospective study in consecutive patients under study because of chronic diarrhoea.

RESULTS

In a 4.5-year period 23 consecutive patients had histological signs of thickening of the subepithelial collagen band in the colon. There was a female predominance: 19 women versus 4 men, mean age 60 years (range 33-83). The stool frequency was 1-13 stools daily. Indicanuria was present in 9 patients. The patients were divided into 3 groups: those with definite collagenous colitis (n = 11; thickness of the collagen band of more than 10 micrometer); those with indefinite collagenous colitis (n = 8; thickness between 3 and 10 micrometer), and those with a collagen band between 1 and 3 micrometer (n = 4). During a mean follow-up of 20 months (range 13-36), 7 patients had waxing and waning episodes of diarrhoea, 11 showed spontaneous waning of complaints and a lower stool frequency. The 9 patients with indicanuria did well after a course of tetracyclin 250 mg t.i.d., but all cases relapsed during follow-up.

CONCLUSION

It is concluded that thickening of the collagen band and collagenous colitis are not as unusual as usually thought.