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Collagenous Colitis, Lymphocytic Colitis
|Disease:||Collagenous Colitis, Lymphocytic Colitis|
Collagenous colitis and lymphocytic colitis are inflammatory conditions of the colon that result in chronic, non-bloody, watery diarrhea. Some researchers consider collagenous colitis and lymphocytic colitis are different phases of the same condition rather than separate conditions.
Since the diagnosis of this condition is confirmed by microscopic examination, both collagenous colitis and lymphocytic colitis are occasionally referred to collectively as microscopic colitis. Collagenous colitis and lymphocytic colitis are more dominant in older adults. Moreover, it is less common in men than in women.
Treatment involves a phased approach, likely changing lifestyle. Fortunately, adjusting the diet will be enough to resolve the symptoms in many cases. However, if that was not enough, the doctor can recommend a number of effective medications for collagenous colitis and lymphocytic colitis. Surgery is hardly ever necessary.
Prepared by: Scientific Section
Collagenous colitis and lymphocytic colitis could affect different portions of the colon. The inflammation seems to be taking place in patches along the lining of the colon in some people, while in others it is present along the whole length of the bowel.
It is not certain why collagenous colitis and lymphocytic colitis occur. Some researchers consider bacteria and toxins that they produce or a virus might trigger the inflammation linked to these conditions. Other investigators came up with theories which indicate that these disorders are autoimmune problems, meaning that the body’s own immune system is overactive and in fact attacks and damages healthy cells, mistakenly recognizing them as foreign invaders.Actually, people with collagenous colitis or lymphocytic colitis usually have one or more additional autoimmune disorders as well. Including the followings:
There have been some reports of collagenous colitis and lymphocytic colitis occurring in families, suggesting a possible genetic component in some cases.
Although other inflammatory diseases of the extended intestine like in the case of Crohn’s disease and ulcerative colitis raise the likelihood of growing cancer of the colon, but there’s no proof that either collagenous colitis or lymphocytic colitis raises the risk of colon cancer or death.
Collagenous colitis often improves without treatment and goes away within weeks. Yet, when the signs and symptoms are serious, doctors in general regard treatment as a necessity. The therapy is the same for both collagenous colitis and lymphocytic colitis. Doctors often recommend a stepwise approach, beginning with the simplest, most easily tolerated treatments aiming to produce the relief of symptoms.
When taking over-the-counter non-steroidal anti-inflammatory medications, like aspirin, ibuprofen and naproxen (Aleve), doctor should be consulted about switching to other kinds of pain relievers. These NSAIDs could make the diarrhea worse related to collagenous colitis and lymphocytic colitis.
Doctors usually suggest beginning with antidiarrheal preparations like loperamide (lmodium) or the combination medication diphenoxylate and atropine (Lomotil) once the diagnosis is made. For many people, specifically those whose diarrhea is mild to moderate, they’re effective treatment, and they’re well tolerated in most cases. In case signs and symptoms do not subside with these medications, the doctor might recommend a different drug, like bismuth subsalicylate (Pepto-Bismol). The cholesterol-lowering medication cholestyramine (Questran) might be used. Cholestyramine helps treating lymphocytic colitis by absorbing bile acids that might be resulting in diarrhea. This drug is related to the side effect of bloating.
If these medications don’t relieve symptoms, the doctor might recommend a course of treatment with a corticosteroid medication like budesonide (Entocort). To decrease the risk of side effects, in general, this medication is taken for a maximum of two months. The corticosteroid known as prednisone might be used for more severe cases, but this medication is related to more side effects than budesonide. After finishing a course of treatment with either of these corticosteroid medications, there might be a chance of recurrence. Other medications that are used to decrease colon swelling and inflammation include anti-inflammatory medications like mesalamine (Asacol, Pentasa) and sulfasalazine (Azulfidine) and immunosuppressive medications like methotrexate (Rheumatrex) and azathioprine (Imuran).More studies are required to see the effectiveness of these medications in the management of collagenous colitis and lymphocytic colitis.
Yaser Habrawi , F.R.C.S.Ed
Dr. Samer Al-Jneidy
Dr . Dirar Abboud
Dr. Tahsin Martini
Dr. Hani Najjar
Dr. Talal Sabouni
Samir Moussa M.D.
Dr. Faisal Dibsi