Re: collagenous colitis

January 3, 1980

Dear Benn and nne

thanks so much for your input -thats really helpful.

regards , Annette

January 14, 2004

Hello Annette,

I searched the web using Google and found plenty of info on collagenous

colitis and copied the below... I turst it helps,

Benn

Collagenous Colitis FAQ

Microscopic colitis (MC) is a name used to describe a chronic diarrheal

syndrome that is caused by inflammation in the colon/large intestine

(i.e., colitis). It is called " microscopic " colitis because the

inflammation can be detected only with a microscope. During an endoscope

procedure (colonoscopy or sigmoidoscopy), the colon looks normal. The

presence or absence of a specific feature within the colonic

inflammatory process as seen under the microscope (thickened collagen

under the surface of the biopsy) has led to use of two other names for

this syndrome: collagenous colitis and lymphocytic colitis.

The authors of scientific journal articles differ in their opinions

about which name to use (microscopic, collagenous, or lymphocytic). Yet,

the symptoms and treatment of this syndrome are virtually identical,

regardless of whether the collagen in the biopsy is thick or normal.

Thus, the name microscopic colitis can be used to include both

collagenous and lymphocytic colitis. In this FAQ, microscopic colitis is

used to refer synonymously to either collagenous or lymphocytic colitis.

Diagnosis is made based upon microscopic analysis of biopsies of the

colon. The " typical " patient is a middle-aged woman; but it is seen in

men, children as young as six and older people also. Possible initial

misdiagnoses include stress, gastroenteritis, celiac sprue, lupus, or

irritable bowel syndrome (IBS). It's not unusual for diagnosis to take

several years, since microscopic colitis is the form of inflammatory

bowel disease least familiar to doctors and often the last considered.

Patients sometimes seek treatment for an elusive form of arthritis as

much as ten years prior to problems with diarrhea. This atypical

arthritis can affect the back, hips and sometimes ribs. It can come and

go, and can change locations. Other associated problems may include:

iritis, purpura, thyroid diseases, pernicious anemia, idiopathic

pulmonary fibrosis, fibromyalgia, unexplained severe itching, mouth

sores, fatigue, depression, mitral valve prolapse and celiac sprue (also

called celiac disease). There does not seem to be an association with

Crohn's disease, ulcerative colitis, or cancer.

Most patients diagnosed with microscopic colitis are Caucasians living

in Northern Europe, Canada, the United States, Australia and New

Zealand. It does not appear to be contagious. Some patients report a

close family member with the same diagnosis or with similar intestinal

symptoms, and it appears there may be a hereditary tendency to get

microscopic colitis.

The major symptom of microscopic colitis is watery diarrhea that may be

severe and sometimes even explosive. Necessary visits to the bathroom

may number up to 30 times a day. In rare cases, the diarrhea may be

severe enough to cause dehydration. Other symptoms may include weakness,

difficulty eating, abdominal bloating, and nausea. The diarrhea may come

in sudden bouts, giving only seconds of warning. There does not seem to

be a consistent dietary factor contributing to diarrheal episodes.

Certain foods, especially high fiber, fat, milk products, spices, wheat

and/or uncooked fruit and vegetables, may aggravate it. On the contrary,

some patients tolerate any foods -- even when quite ill. Many have

difficulty eating wheat, oats, bran and rye because they induce

abdominal symptoms and diarrhea. This fact, as well as other scientific

evidence, indicates that there may be clinical overlap of microscopic

colitis with a disease called celiac sprue. Celiac sprue is caused by an

immunologic reaction of the intestine to wheat, barley, rye, and oats.

Approximately half of the patients with microscopic colitis report a

sudden onset. They can pin down the exact day and location that symptoms

started, often triggered by an initial bout with dysentery, giardia, or

an undiagnosed intestinal illness.

One theory is that the inflammatory response is caused by a bacterium or

a bacterial toxin. Another theory suggests this is an autoimmune

disease, although that hasn't been conclusively established. A third

suggests that non-steroidal anti-inflammatory drugs (NSAIDs, such as

aspirin or ibuprofen) might be responsible or aggravate the symptoms in

individuals predisposed to the disease by another mechanism. It may well

turn out to be a combination of several of these factors.

TREATMENT:

Useful information has been sparse. This illness can come and go, with

or without treatment, making it difficult to assess the effect of any

treatment plan. Traditionally, treatment is started with sulfasalazine.

Patients may improve with sulfasalazine, but they are not necessarily

cured. For the many that don't tolerate sulfasalazine, Asacol (one brand

of mesalamine or 5-aminosalicylic acid) is typically prescribed. These

medicines are thought to act as anti-inflammatory agents in the

intestine.

Anti-diarrheal medications such as Imodium and Lomotil are used for

temporary relief, but tend to merely delay the diarrhea.

Studies done with prednisone (a corticosteroid) do not sound very

promising for long-term use. Most patients do respond quickly to this

agent, so it can be useful to stop a severe attack. However, the

diarrhea routinely returns when prednisone is discontinued. Long-term

use of prednisone is discouraged because the side effects (formation of

cataracts, bone degeneration, high blood pressure, and a tendency toward

diabetes) can eventually be worse than the benefits.

Some people report excellent short-term results with certain

antibiotics; however, the results generally are not long lasting.

A cholesterol-lowering drug called cholestyramine is helpful to some.

Fiber in the form of psyllium hydrophilic mucilloid (like Metamucil)

also helps some patients, but not others. Low dose tricyclic

antidepressants (such as Doxepin or Elavil) can sometimes help with the

joint and muscle pain.

Surgical removal of the colon with formation of an ileostomy is a

radical approach and is seldom used.

--

Benn Abdy- MCPP

Medical Herbalist

Windsor, Newquay, London

0 or 07957 65 88 90

January 14, 2004

could there be some endometriosis, particularly on the outside of the

bowel??

====================================================

nne Last BA MNIMH, Consultant Medical Herbalist

Tel/Fax: 01600 719497

www.mariannelast.co.uk

collagenous colitis

Dear all

has anyone come across this before ?I saw a patient about a month ago for

svere chronic diarrheoa which had been getting worse ove r the last year.

she was awaiting various tests from her consultant.I gave her a mix which

reduced the frequency of bowel movements and allowed her to sleep through

the night. she had been on the verge of cancelling a trip to India but

because of the improvement decided to go ahead.However the week she was due

to go she saw her consultant who gave her the diagnosis of collagenous

colitis which is apparently where the body lays down an extra layer of

collagen inside the bowel.The day before she was due to fly her symptoms got

worse and so she had to cancel her holiday.She says she has noted a strong

link between her symptoms and her period which I guesss is not that unusual

for bowel problems but has anyone any ideas on best treatment apart from

general colitis approaches.Her consultant has given her 9mg per day of

budesonide which she is very reluctant to take but is under pressure from

husband.Her symptoms by the way are subsiding as her period is finishing.

any advice would be very welcome

thanks , Annette

January 17, 2004

Dear Annette,

I had a patient with Collagenous Colitis last year; I had never heard of it

before, but gave her the following mix, not really expecting much success:

Thuja -5

Curcuma (Fe) -10

Glycyrrhiza (Fe) -10

Dioscorea (Fe) -15

Althaea rad -15

Calendula 25% -15

Centella -15

Symphytum fol -20

5ml TID PC.

She phoned to cancel her follow-up visit because her diarrhoea had stopped

completely, and has had repeat prescriptions for a few months now. Obviously

what works for one person may not work for another, but hope this is

helpful,

Helen.

collagenous colitis

> Dear all

> has anyone come across this before ?I saw a patient about a month ago for