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Inflammatory Bowel Disease
Published in Mary J. Marian, Gerard E. Mullin, Integrating Nutrition Into Practice, 2017
Boswellia serrata is a plant native to India, which has been used for hundreds of years as a herbal remedy for inflammatory conditions. B. serrata is a leukotriene inhibitor leading to a blunted release of pro-inflammatory cytokines explaining its anti-inflammatory effects [106]. Gupta et al. demonstrated an improvement in 70% of UC patients treated with B. serrata, which was equally as effective as sulfasalazine therapy [107]. Gerhardt et al. found that B. serrata was equivalent to mesalamine in the treatment of CD [108]. A double-blind randomized controlled trial of 108 patients confirmed the safety and patient tolerability of B. serrata, although it was not efficacious in maintaining remission in CD patients after 52 weeks of therapy [109]. Another study demonstrated a possible improvement of collagenous colitis treated with B. serrata, although due to a high drop-out rate, only the per-protocol analysis was statistically significant.
Other disease associations: Liver, gastrointestinal, respiratory, and neoplastic
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
The term “microscopic colitis” was initially coined in the 1980s to describe a noninfectious chronic diarrheal disease characterized by histological changes in the presence of endoscopically normal or near normal mucosa. It is an inflammatory condition of the colon of unknown etiology and currently includes two histologically distinct entities, termed lymphocytic colitis and collagenous colitis. The disease is presented clinically with watery diarrhea, crampy abdominal pain, nausea, and weight loss, and, as mentioned, it requires histological demonstration of specific abnormalities of the endothelial colonic mucosa for its diagnosis. As opposed to what is seen in IBD, extraintestinal manifestations are rare in microscopic colitis.34,35
Clostridium difficile Infection: Overview and Update with a Focus on Antimicrobial Resistance as a Risk Factor
Published in Robert C. Owens, Lautenbach Ebbing, Antimicrobial Resistance, 2007
Robert C. Owens, August J. Valenti, Mark H. Wilcox
PPIs have been shown to cause diarrhea with or without specific histologic findings from biopsy specimens obtained during colonoscopy (forms of microscopic colitis such as lymphocytic and collagenous colitis) (63,64). And in some of these cases of collagenous colitis, pseudomembranes have been identified (65). Clinicians should be mindful of this as colitis caused by PPIs may interfere with, confuse, or delay the diagnosis of CDI.
Fecal calprotectin level in microscopic colitis: a systematic review and meta-analysis
Published in Baylor University Medical Center Proceedings, 2023
Busara Songtanin, Chanaka Kahathuduwa, Kenneth Nugent
We conducted this meta-analysis according to Cochrane’s manual of diagnostic test accuracy, and the manuscript was prepared according to the preferred reporting items for systematic reviews and meta-analysis of diagnostic test accuracy (PRISMA-DTA) guidelines.4,5 A literature search of PubMed, Embase, and Scopus was conducted from database inception through September 2022. Search terms included (a) microscopic colitis, collagenous colitis, and lymphocytic colitis, (b) fecal calprotectin. Only studies evaluating an adult population were included. Case series and case reports were excluded from this study. Non-English publications were also excluded if data could not be extracted. The titles and abstracts were reviewed by two independent authors (B.S. and C.K.). Discrepancies were resolved through discussion between them and the senior author (K.N.). Two independent authors compiled data from each study including study characteristics, study population characteristics, and study results. Study characteristics included author, year of publication, start and end dates for data collection, country, and type of study design. Quality assessment was performed using QUADAS-2 by two independent authors (B.S. and C.K.).6 Any discrepancies were resolved through discussion between them with the senior author (K.N.). Interobserver agreement was evaluated by Cohen’s kappa coefficient.
Abnormal findings on abdominopelvic cross-sectional imaging in patients with microscopic colitis: a retrospective, multicenter study
Published in Scandinavian Journal of Gastroenterology, 2022
Andree H. Koop, Ahmed Salih, Mohamed Omer, Josh Kwon, Hassan M. Ghoz, Matthew McCann, June Tome, William C. Palmer, Darrell S. Pardi, Fernando F. Stancampiano
Although the presence of collagenous colitis and endoscopic abnormalities did not meet statistical significance, they were more common in patients with radiographic abnormalities. Collagen deposition, defined as a thickened subepithelial collagen band >10µm, seen in collagenous colitis may lead to mural wall thickening detectable with cross-sectional imaging [3,13]. In the majority of patients (62.9%) with imaging abnormalities, one or two segments of the colon were involved, whereas only 6 patients had pan-colonic findings. Although the distribution of MC is often diffuse, it may be isolated to either the right or left colon, possibly explaining the regional distribution of radiographic abnormalities in our population [14]. A recent study demonstrated that histologic findings of microscopic colitis occur within most colon segments, although inflammatory changes and thickness of the subepithelial collagen band in collagenous colitis are greater in the proximal colon [15]. A limitation of this study is that we were not able to map out the distribution of MC by colon segment, and we are therefore unable to determine if segmental abnormalities seen on imaging correlate with segmental histologic involvement.
Campylobacter concisus is prevalent in the gastrointestinal tract of patients with microscopic colitis
Published in Scandinavian Journal of Gastroenterology, 2020
Marta Emilie Yde Aagaard, Karina Frahm Kirk, Hans Linde Nielsen, Irene Harder Tarpgaard, Jesper Bach Hansen, Henrik Nielsen
Microscopic colitis (MC) is an inflammatory bowel disease (IBD) of the colon and rectum, encompassing the histological subtypes collagenous colitis (CC) and lymphocytic colitis (LC) [1]. There is no difference in clinical appearance or treatment [2]. MC causes chronic watery diarrhoea and in some patients faecal urgency and incontinence, resulting in a great decrease in health-related quality of life [1,3]. Incidence rates of MC vary worldwide, but are increasing [4]. Incidence rates as high as 24.7 per 100,000 have been reported in Denmark [5], which is comparable to classic IBD (25.9 per 100,000) [6]. Risk of MC increases with age, and the mean age at diagnosis is 67 years for CC and 64 years for LC [5]. Furthermore, MC is more frequent among women, with female/male ratios of 3.1/1.0 for CC and 1.8/1.0 for LC (1,5). The pathogenesis of MC remains unclear, but is associated with smoking and use of PPIs [7,8]. In addition, use of menopausal hormone therapy may, to some extent, explain the female predominance [9]. To date, the association with gut bacteria has been poorly described. However, bacteria specific to intestinal mucosal protection may be reduced in the faecal microbiota of MC patients [10–12].