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Collagenous colitis (CC) is a condition that affects your large intestine. It leads to episodes of watery diarrhea and belly pain.
Your large intestine is part of your digestive (gastrointestinal or GI) tract. The GI tract goes from your mouth all the way to your rectal opening. The large intestine includes both the colon and the rectum. The large intestine receives the broken-down products of food from the small intestine. One of its main jobs is to reabsorb water and electrolytes, such as salt. The colon leads to the rectum. The rectum stores your bowel movements before your body eliminates them.
In CC, inflammatory cells from your immune system travel to your large intestine. There they cause swelling and inflammation. In rare cases, these cells also go into the latter part of your small intestine.
This inflammation may keep your large intestine from reabsorbing as much water as it should. This can lead to diarrhea, belly pain, and other symptoms. The inflammation may also cause extra collagen to build up in the wall of your small intestine. Collagen is a stretchy, supportive substance.
CC is one type of inflammatory bowel disease (IBD). IBD is group of conditions that cause inflammation in either the small or large intestine. CC is a type of microscopic colitis. Microscopic colitis is inflammation of the large intestine that can only be seen through a microscope. The other main type of microscopic colitis is lymphocytic colitis. Some experts think lymphocytic colitis and CC might be the same illness presented in different ways.
CC is pretty uncommon. It’s more common in older adults. But it can affect younger adults and children. It’s also seen more in women than in men.
Experts are trying to understand what causes the inflammation of the large intestine that leads to CC. Some people think that something in the GI tract triggers this abnormal immune response. This might be bacteria, pollen, or food.
Taking certain medicines may also trigger the condition in some people. These medicines can include:
Certain bacteria may trigger CC in some people. You might have your first episode after getting sick from bacteria. These can include Campylobacter jejuni or Clostridium difficile. Toxins in these bacteria may harm the inner surface of your large intestine. This can cause inflammation. Some experts think certain viruses may also play a role in CC.
Some foods may bring on the condition in some people. Certain foods may also make CC symptoms worse. These can include caffeine and milk products.
Having certain health issues may increase your risk for the disease. These include:
Being a smoker may increase your risk for the condition. Smoking interferes with the blood flow that your intestines need. Your risk for CC may also be higher if someone in your family has the condition or another inflammatory bowel disease.
The main symptom of CC is watery diarrhea. This diarrhea does not have blood. You may have several of these watery bowel movements each day. This may last for weeks or months. For most people, this diarrhea goes away for a while, but then it comes back later.
Other symptoms of CC may include:
You may need to see a gastroenterologist. This is a doctor with special training to treat problems with the digestive system.
Your healthcare provider will ask you about your health history. He or she will also ask about your symptoms. Your provider will give you an exam, including an exam of your abdomen.
Your healthcare provider will rule out other causes of your diarrhea. These can include an infection or another inflammatory bowel disease.
Your healthcare provider will also do other tests. These may include:
You may also need a colonoscopy. This test looks at the lining of your colon and rectum. It uses a light and a tiny camera.
The colon often looks normal on a colonoscopy. During the colonoscopy, your healthcare provider can take out a small part of your colon. Then he or she will look at it under a microscope to tell if you have CC.
Your healthcare provider may prescribe medicines and suggest diet changes to treat your CC.
Your healthcare provider may give you antidiarrheal medicines. You may also need mesalamine or cholestyramine, if you still have symptoms.
If you are taking medicines that make your symptoms worse, your healthcare provider may stop your treatment with those medicines.
Most people only need to take medicines for a short time. The majority of people respond well to medicines. If your symptoms come back, you might need to start taking these medicines again for a short time.
You may need to avoid foods that make your diarrhea worse. These can include dairy products, caffeine, artificial sweeteners, and foods high in fat. Some people with this condition also do well on a gluten-free diet.
If you don’t respond well to treatment, your healthcare provider may look for other possible causes of your symptoms. In rare cases, healthcare providers recommend surgery to take out part of the intestines.
Unlike other forms of inflammatory bowel disease, CC doesn’t seem to increase your risk for colon cancer. It does not increase your risk of death from any cause.
Call your healthcare provider if your symptoms don’t go away with treatment. Your healthcare provider may change your treatment plan.
Tips to help you get the most from a visit to your health care provider:
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