COLLAGENOUS COLITIS - A RETROSPECTIVE STUDY OF CLINICAL PRESENTATION AND TREATMENT IN 163 PATIENTS

Background-Data on collagenous colitis have been based on a limited nu mber of patients. Aims-To obtain more information on this disease from a register set up at Orebro Medical Center Hospital, Patients and Met hods-Twenty five Swedish hospitals have contributed to this patient re gister, which comprises 163 histopathologically verified cases, Clinic al data were retrospectively analysed. Results-Collagenous colitis fol lowed a chronic intermittent course in most cases (85%) with a sudden onset in 42%. Symptoms were chronic watery diarrhoea, often nocturnal (27%), abdominal pain (41%), and weight loss (42%). Sixty six patients (40%) had one or more associated diseases. Routine laboratory data we re mostly normal, The median age at diagnosis was 55 (range 16-86) yea rs, bur 25% of the patients were younger than 45 years. Seven patients died of unrelated diseases. The response rate for sulphasalazine was 59%, and 50% and 40% for mesalazine and olsalazine. Prednisolone was m ost effective with a response rate of 82%, but the required dose was o ften high and the effect was not sustained after withdrawal. Antibioti cs were efficient in 63%. Cholestyramine and loperamide had response r ates of 59% and 71% respectively. Conclusions-Collagenous colitis foll ows a chronic continuous course. Symptoms can be socially disabling, b ut the disease does not seem to have a malignant potential. A plan for the treatment of a newly diagnosed patient with collagenous colitis I s proposed.