Pathology of the Gastrointestinal Tract

2017 Edition
| Editors: Fátima Carneiro, Paula Chaves, Arzu Ensari

Collagenous Colitis

  • Arzu EnsariEmail author
Reference work entry


Chronic watery diarrhea; Microscopic colitis


Collagenous colitis (CC) is defined as a chronic nondistorting colitis with the deposition of characteristic thick collagen band immediately beneath the surface epithelium. This layer has an irregular, jagged lower edge and consists of collagen fibers, inflammatory cells, and capillaries. The average collagen width has been reported as 10–20 μm, compared with the normal basement membrane width of up to 3 μm. Patients with CC generally suffer from chronic watery diarrhea. Colonoscopy is usually normal or near normal.

Clinical Features

  • Incidence

    The reported incidence is between 1 and 2 in 100,000.

  • Age

    Primarily affects middle-aged or older adults.

  • Sex

    There is slight female predominance over males as 1.8:1.

  • Site

    CC involves the entire colon in a patchy fashion. In some cases there may be rectal or left colonic sparing.

  • Treatment

    Most patients with CC require anti-inflammatory therapy with either steroids or 5-ASA compounds.

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References and Further Reading

  1. Fernández-Bañares, F., Salas, A., Esteve, M., et al. (2003). Collagenous and lympho-cytic colitis: Evaluation of clinical and histological features, response to treatment, and long-term follow-up. The American Journal of Gastroenterology, 98, 340–347.PubMedGoogle Scholar
  2. Lazenby, A. J., Yardley, J. H., Giardiello, F. M., et al. (1990). Pitfalls in the diagnosis of collagenous colitis: Experience with 75 cases from a registry of collagenous colitis at the Johns Hopkins Hospital. Human Pathology, 21, 905–910.PubMedGoogle Scholar
  3. Lindstrom, C. G. (1976). ‘Collagenous colitis’ with watery diarrhoea: A new entity? Pathologia Europaea, 11, 87–89.PubMedGoogle Scholar
  4. Widgren, S., Jlidi, R., & Cox, J. N. (1988). Collagenous colitis: Histologic morphometric immunohistochemical and ultrastructural studies. Report of 21 cases. VirchowsArchiv Anatomy, 413, 287–296.Google Scholar
  5. Yuan, S., Reyes, V., & Bronner, M. P. (2003). Pseudomembranous collagenous colitis. The American Journal of Surgical Pathology, 27, 1375–1379.PubMedGoogle Scholar
  6. Langner C, Aust D, Ensari A, Villanacci V, Becheanu G, Miehlke S, Geboes K, Münch A. (2015). Working Group of Digestive Diseases of the European Society of Pathology (ESP) and the European Microscopic Colitis Group (EMCG). Histology of microscopic colitis-review with a practical approach for pathologists. Histopathology, 66(5), 613–626.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PathologyAnkara University Medical SchoolSihhiyeTurkey