Inflammatory Bowel Disease
Mary J. Marian, Gerard E. Mullin in 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
M. Alan Menter, Caitriona Ryan in 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
Irritable Bowel Syndrome
Kevin W. Olden in Handbook of Functional Gastrointestinal Disorders, 2020
The diagnosis of IBS is based on the positive identification of symptoms consistent with the disorder, and by excluding other etiologies that produce similar symptoms. If another etiology is found to explain the patient’s symptoms (e.g., lactase deficiency, collagenous colitis, pelvic dyssynergia), the patient may not have IBS, and more specific treatment is undertaken. However, given the high prevalence of IBS symptoms in the population, it is also likely that IBS may coexist with other disorders. In these situations, treatment depends on assessing the role of all contributing factors.
Microscopic colitis in patients with ulcerative colitis or Crohn’s disease: a retrospective observational study and review of the literature
Published in Scandinavian Journal of Gastroenterology, 2018
Anna Wickbom, Johan Bohr, Nils Nyhlin, Anders Eriksson, Annika Lapidus, Andreas Münch, Kjell-Arne Ung, Lina Vigren, Åke Öst, Curt Tysk
Ulcerative colitis (UC) and Crohn’s disease (CD), the two major forms of inflammatory bowel disease (IBD), have been known for a long time [1]. Collagenous colitis (CC) and lymphocytic colitis (LC), together constituting microscopic colitis (MC), are in this respect fairly new conditions, described in 1976 and 1989, respectively [2,3]. UC, CD and MC differ regarding epidemiology, clinical presentations, endoscopic and histopathologic features. Ulcerative colitis and CD generally have an onset early in life at 20–40 years of age [4], whereas onset of CC and LC is generally later in life, with a peak incidence rate around 60–70 years of age [5]. The typical clinical presentation of UC and CD is diarrhoea, rectal bleeding, abdominal pain or fever, whereas watery, non-bloody diarrhoea is characteristic for CC and LC. The endoscopic appearance of UC and CD displays macroscopic signs of inflammation and ulcerations, whereas the colonic mucosa in MC is generally normal. Furthermore, histopathologic findings are different.
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].
Collagenous colitis without diarrhoea at diagnosis – a follow up study
Published in Scandinavian Journal of Gastroenterology, 2019
Mari Thörn, Daniel Sjöberg, Tommy Holmström, Anders Rönnblom
Frequent, watery diarrhoea is a classical symptom of collagenous colitis (CC). However, in some cases, the typical histologic appearance, thickened collagen layer of at least 10 µm together with signs of inflammation [1], can be found in patients without this symptom. This was described already in 1988 in three patients with constipation [2] and in a case report from 1993 after surgery for constipation [3] . In the ICURE cohort (the IBD Cohort Uppsala Region), we have identified incident cases of inflammatory bowel disease (IBD) and microscopic colitis (MC) in the Uppsala health care region during the years 2005-2009 [4–6]. We identified 272 cases of MC, 154 with CC and 118 with lymphocytic colitis (LC). In almost 10% (15/154), of the CC cases, the patients lacked the typical symptom, watery diarrhoea [5].