Clin Colon Rectal Surg 2007; 20(1): 047-057
DOI: 10.1055/s-2007-970200
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Noninfectious Colitides: Collagenous Colitis, Lymphocytic Colitis, Diversion Colitis, and Chemically Induced Colitis

Amy J. Thorsen1
  • 1Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, St. Paul, Minnesota
Further Information

Publication History

Publication Date:
28 February 2007 (online)

ABSTRACT

Approximately 10% of patients with chronic diarrhea carry a diagnosis of microscopic colitis. The endoscopic appearance of both collagenous colitis and lymphocytic colitis may be normal; however, biopsies confirm the diagnosis. Available treatments include antidiarrheals, bismuth salicylate, and budesonide. Although most patients with fecal diversion may have endoscopic evidence of colitis, a much smaller percentage of patients are symptomatic. Some cases of diversion colitis respond to treatment with short-chain fatty acid enemas; however, return of the fecal stream is the most successful therapy. A variety of oral, intravenous, and per rectum chemicals may cause colitis; symptoms usually abate when chemical exposure is discontinued.

REFERENCES

  • 1 Raclot G, Queneau P E, Ottignon Y et al.. Incidence of collagenous colitis. A retrospective study in the east of France.  Gastroenterology. 1994;  106 A23
  • 2 Olesen M, Eriksson S, Bohr J, Järnerot G, Tysk C. Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993-1998.  Gut. 2004;  53 346-350
  • 3 Bohr J, Tysk C, Eriksson S, Jarnerot G. Collagenous colitis in Orebro, Sweden, an epidemiological study 1984- 1993.  Gut. 1995;  37 394-397
  • 4 Nielsen O H, Vainer B, Schaffalitzky de Muckadell O B. Microscopic colitis: a missed diagnosis?.  Lancet. 2004;  364 2055-2057
  • 5 Jaskiewicz K, Rzepko R, Adrych K, Smoczyński M. Microscopic colitis in routine biopsies.  Dig Dis Sci. 2006;  51 241-244
  • 6 Giardiello F M, Lazenby A J, Bayless T M. Lymphocytic (microscopic) colitis. Clinicopathologic study of 18 patients and comparison to collagenous colitis.  Dig Dis Sci. 1989;  34 1730-1738
  • 7 Chande N, Driman D K, Reynolds R P. Collagenous colitis and lymphocytic colitis: patient characteristics and clinical presentation.  Scand J Gastroenterol. 2005;  40 343-347
  • 8 Koskela R M, Niemelä S E, Karttunen T J, Lehtola J K. Clinical characteristics of collagenous and lymphocytic colitis.  Scand J Gastroenterol. 2004;  39 837-845
  • 9 Zins B J, Sandborn W J, Tremaine W J. Collagenous and lymphocytic colitis: subject review and therapeutic alternatives.  Am J Gastroenterol. 1995;  90 1394-1400
  • 10 Gremse D A, Boudreaux C W, Manci E A. Collagenous colitis in children.  Gastroenterology. 1993;  104 906-909
  • 11 Chutkan R, Sternthal M, Janowitz H D. A family with collagenous colitis, ulcerative colitis, and Crohn's disease.  Am J Gastroenterol. 2000;  95 3640-3641
  • 12 Van Tilburg A JP, Lam H GT, Sedlenrijk C A et al.. Familial occurrence of collagenous colitis: a report of two families.  J Clin Gastroenterol. 1990;  12 279-285
  • 13 Bohr J, Tysk C, Eriksson S, Abrahamsson H, Jarnerot G. Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.  Gut. 1996;  39 846-851
  • 14 Kingham J GC, Levison D A, Morson B C, Dawson A M. Collagenous colitis.  Gut. 1986;  27 570-577
  • 15 Roubenoff R, Ratain J, Giardiello F et al.. Collagenous colitis, enteropathic arthritis, and autoimmune diseases: results of a patient survey.  J Rheumatol. 1989;  16 1229-1232
  • 16 Zins B J, Tremaine W J, Carpenter H A. Collagenous colitis: mucosal biopsies and association with fecal leukocytes.  Mayo Cin Proc. 1995;  70 430-433
  • 17 Rask-Madsen J, Grove O, Hansen M G et al.. Colonic transport of water and electrolytes in a patient with secretory diarrhea due to collagenous colitis.  Dig Dis Sci. 1983;  28 1141-1146
  • 18 Lettesjö H, Hansson T, Peterson C et al.. Detection of inflammatory markers in stools from patients with irritable bowel syndrome and collagenous colitis.  Scand J Gastroenterol. 2006;  41 54-59
  • 19 Kakar S, Pardi D S, Burgart L J. Colonic ulcers accompanying collagenous colitis: implication of nonsteroidal anti-inflammatory drugs.  Am J Gastroenterol. 2003;  98 1834-1837
  • 20 Giardiello F M, Hansen 3rd F C, Lazenby A J et al.. Collagenous colitis in setting of nonsteroidal antiinflammatory drugs and antibiotics.  Dig Dis Sci. 1990;  35 257-260
  • 21 Yuan S, Reyes V, Bronner M P. Pseudomembranous collagenous colitis.  Am J Surg Pathol. 2003;  27 1375-1379
  • 22 Fernández-Bañares F, Salas A, Forné M, Esteve M, Espinós J, Viver J M. Incidence of collagenous and lymphocytic colitis: a 5-year population-based study.  Am J Gastroenterol. 1999;  94 418-423
  • 23 Carpenter H A, Tremaine W J, Batts K P, Czaja A J. Sequential histologic evaluations in collagenous colitis. Correlations with disease behavior and sampling strategy.  Dig Dis Sci. 1992;  37 1903-1909
  • 24 Thijs W J, van Baarlen J, Kleibeuker J H, Kolkman J J. Microscopic colitis: prevalence and distribution throughout the colon in patients with chronic diarrhoea.  Neth J Med. 2005;  63 137-140
  • 25 Fine K D, Schiller L R. AGA technical review on the evaluation and management of chronic diarrhea.  Gastroenterology. 1999;  116 1464-1486
  • 26 Nielsen O H, Vainer B, Schaffalitzky de Muckadell O B. Microscopic colitis: a missed diagnosis?.  Lancet. 2004;  364 2055-2057
  • 27 Shaz B H, Reddy S I, Ayata G et al.. Sequential clinical and histopathological changes in collagenous and lymphocytic colitis over time.  Mod Pathol. 2004;  17 395-401
  • 28 Kiesslich R, Hoffman A, Goetz M et al.. In vivo diagnosis of collagenous colitis by confocal endomicroscopy.  Gut. 2006;  55 591-592
  • 29 Cammarota G, Pignataro F, Cuoco L et al.. EUS in the diagnosis of collagenous colitis.  Gastrointest Endosc. 2001;  54 113-115
  • 30 Jessurun J, Yardley J H, Giardiello F M, Hamilton S R, Bayless T M. Chronic colitis with thickening of the subepithelial collagen layer (collagenous colitis): histopathologic findings in 15 patients.  Hum Pathol. 1987;  18 839-848
  • 31 Armes J, Gee D C, Macrae F A, Schroeder W, Bhathal P S. Collagenous colitis: jejunal and colorectal pathology.  J Clin Pathol. 1992;  45 784-787
  • 32 Aigner T, Neureiter D, Müller S et al.. Extracellular matrix composition and gene expression in collagenous colitis.  Gastroenterology. 1997;  113 136-143
  • 33 Offner F A, Jao R V, Lewin K J, Havelec L, Weinstein W M. Collagenous colitis: a study of the distribution of morphological abnormalities and their histological detection.  Hum Pathol. 1999;  30 451-457
  • 34 Rubio C A. A simple method to evaluate the thickness of collagen in collagenous colitis.  Scand J Gastroenterol. 2000;  35 223-224
  • 35 Rubio C A, Slezak P. The subepithelial band in collagenous colitis is autofluorescent a study in H&E stained sections.  In Vivo. 2002;  16 123-126
  • 36 Bohr J, Tysk C, Yang P et al.. Autoantibodies and immunoglobulins in collagenous colitis.  Gut. 1996;  39 73-76
  • 37 Järnerot G, Tysk C, Bohr J et al.. Collagenous colitis and fecal stream diversion.  Gastroenterology. 1995;  109 449-455
  • 38 Wilcox G M, Mattia A. Collagenous colitis associated with lansoprazole.  J Clin Gastroenterol. 2002;  34 164-166
  • 39 Duncan H D, Talbot I C, Silk D B. Collagenous colitis and cimetidine.  Eur J Gastroenterol Hepatol. 1997;  9 819-820
  • 40 Bohr J, Nordfelth R, Järnerot G, Tysk C. Yersinia species in collagenous colitis: a serologic study.  Scand J Gastroenterol. 2002;  37 711-714
  • 41 Nishida Y, Murase K, Isomoto H et al.. Different distribution of mast cells and macrophages in colonic mucosa of patients with collagenous colitis and inflammatory bowel disease.  Hepatogastroenterology. 2002;  49 678-682
  • 42 Schwab D, Hahn E G, Raithel M. Enhanced histamine metabolism: a comparative analysis of collagenous colitis and food allergy with respect to the role of diet and NSAID use.  Inflamm Res. 2003;  52 142-147
  • 43 Ståhle-Bäckdahl M, Maim J, Veress B, Benoni C, Bruce K, Egesten A. Increased presence of eosinophilic granulocytes expressing transforming growth factor-beta1 in collagenous colitis.  Scand J Gastroenterol. 2000;  35 742-746
  • 44 Taha Y, Raab Y, Larsson A et al.. Mucosal secretion and expression of basic fibroblast growth factor in patients with collagenous colitis.  Am J Gastroenterol. 2003;  98 2011-2017
  • 45 Griga T, Tromm A, Schmiegel W, Pfisterer O, Müller K M, Brasch F. Collagenous colitis: implications for the role of vascular endothelial growth factor in repair mechanisms.  Eur J Gastroenterol Hepatol. 2004;  16 397-402
  • 46 Reinders C I, Hellström P M, Björk J, Weitzberg E, Lundberg J O. Effect of intravenous L-NMMA on nitric oxide production in collagenous colitis.  Scand J Gastroenterol. 2004;  39 32-36
  • 47 Ung K A, Gillberg R, Kilander A, Abrahamsson H. Role of bile acids and bile acid binding agents in patients with collagenous colitis.  Gut. 2000;  46 170-175
  • 48 Jarnerot G, Tysk C, Bohr J, Eriksson S. Collagenous colitis and fecal stream diversion.  Gastroenterology. 1995;  109 449-455
  • 49 Madisch A, Miehlke S, Eichele E et al.. Boswellia serrata extract for the treatment of collagenous colitis: a randomized, double-blind, placebo-controlled, multicenter trial.  Gastroenterology. 2005;  128(Suppl 2) A58
  • 50 Chande N, McDonald J WD, MacDonald J K. Interventions for treating collagenous colitis. Cochrane Database Syst Rev 2005, Issue 4
  • 51 Fine K, Ogunji F, Lee E, Lafon G, Tanzi M. Randomized, doubleblind, placebo-controlled trial of bismuth subsalicylate for microscopic colitis.  Gastroenterology. 1999;  116 A880
  • 52 Madisch A, Heymer P, Voss C et al.. Oral budesonide therapy improves quality of life in patients with collagenous colitis.  Int J Colorectal Dis. 2005;  20 312-316
  • 53 Miehlke S, Madisch A, Voss C et al.. Long-term follow-up and predictive factors for clinical relapse in patients with collagenous colitis after induction of remission with budesonide capsules.  Gastroenterology. 2004;  126(Suppl 2) A465
  • 54 Goff J S, Barnett J L, Pelke T et al.. Collagenous colitis: histopathology and clinical course.  Am J Gastroenterol. 1997;  92 57-60
  • 55 Alikhan M, Cummings O W, Rex D. Subtotal colectomy in a patient with collagenous colitis associated with colonic carcinoma and systemic lupus erythematosus.  Am J Gastroenterol. 1997;  92 1213-1215
  • 56 Aqel B, Bishop M, Krishna M, Cangemi J. Collagenous colitis evolving into ulcerative colitis: a case report and review of the literature.  Dig Dis Sci. 2003;  48 2323-2327
  • 57 Giardiello F M, Jackson F W, Lazenby A J. Metachronous occurrence of collagenous colitis and ulcerative colitis.  Gut. 1991;  32 447-449
  • 58 Agnarsdottir M, Gunnlaugsson O, Orvar K B et al.. Collagenous and lymphocytic colitis in Iceland.  Dig Dis Sci. 2002;  47 1122-1128
  • 59 Baert F, Wouters K, D'Haens G et al.. Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis.  Gut. 1999;  45 375-381
  • 60 LaSala P R, Chodosh A B, Vecchio J A, Schned L M, Blaszyk H. Seasonal pattern of onset in lymphocytic colitis.  J Clin Gastroenterol. 2005;  39 891-893
  • 61 Pardi D S, Ramnath V R, Loftus Jr E V, Tremaine W J, Sandborn W J. Lymphocytic colitis: clinical features, treatment, and outcomes.  Am J Gastroenterol. 2002;  97 2829-2833
  • 62 Olesen M, Eriksson S, Bohr J, Järnerot G, Tysk C. Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients.  Gut. 2004;  53 536-541
  • 63 Tsang P, Rotterdam H. Biopsy diagnosis of colitis: possibilities and pitfalls.  Am J Surg Pathol. 1999;  23 423-430
  • 64 Lazenby A J, Yardley J H, Giardiello F M, Jessurun J, Bayless T M. Lymphocytic (“microscopic”) colitis: a comparative histopathologic study with particular reference to collagenous colitis.  Hum Pathol. 1989;  20 18-28
  • 65 Mahajan L, Wyllie R, Goldblum J. Lymphocytic colitis in a pediatric patient: a possible adverse reaction to carbamazepine.  Am J Gastroenterol. 1997;  92 2126-2127
  • 66 Beaugerie L, Patey N, Brousse N. Ranitidine, diarrhea, and lymphocytic colitis.  Gut. 1995;  37 708-711
  • 67 Piche T, Raimondi V, Schneider S et al.. Acarbose and lymphocytic colitis.  Lancet. 2000;  356 1246
  • 68 Giardiello F M, Lazenby A J, Yardley J H et al.. Increased HLA A1 and diminished HLA A3 in lymphocytic colitis compared to controls and patients with collagenous colitis.  Dig Dis Sci. 1992;  37 496-499
  • 69 Helal T E, Ahmed N S, El Fotoh O A. Lymphocytic colitis: a clue to bacterial etiology.  World J Gastroenterol. 2005;  11 7266-7271
  • 70 Ung K A, Kilander A, Willén R, Abrahamsson H. Role of bile acids in lymphocytic colitis.  Hepatogastroenterology. 2002;  49 432-437
  • 71 Baert D, Coppens M, Burvenich P et al.. Chronic diarrhoea in noncollagenous microscopic colitis: therapeutic effect of cholestyramine.  Acta Clin Belg. 2004;  59 258-262
  • 72 Van Gossum A, Schmit A, Peny M O. Oral budesonide for lymphocytic colitis.  Am J Gastroenterol. 1998;  93 270
  • 73 Varghese L, Galandiuk S, Tremaine W J, Burgart L J. Lymphocytic colitis treated with proctocolectomy and ileal J-pouch-anal anastomosis: report of a case.  Dis Colon Rectum. 2002;  45 123-126
  • 74 Mullhaupt B, Güller U, Anabitarte M, Güller R, Fried M. Lymphocytic colitis: clinical presentation and long term course.  Gut. 1998;  43 629-633
  • 75 Bonner G F, Petras R E, Cheong O et al.. Short- and long-term follow-up of treatment for lymphocytic and collagenous colitis.  Inflamm Bowel Dis. 2000;  6 85-91
  • 76 Glotzer D J, Glick M E, Goldman H. Proctitis and colitis following diversion of the faecal stream.  Gastroenterology. 1981;  80 438-441
  • 77 Morson B P, Dawson I MP. Gastrointestinal Pathology. 1st ed. London; Blackwell Scientific Publications 1972
  • 78 Ferguson C M, Siegel R J. A prospective evaluation of diversion colitis.  Am Surg. 1991;  57 46-49
  • 79 Orsay C P, Kim D O, Pearl R K, Abcarian H. Diversion colitis in patients scheduled for colostomy closure.  Dis Colon Rectum. 1993;  36 366-367
  • 80 Whelan R L, Abramson D, Kim D S, Hashmi H F. Diversion colitis. A prospective study.  Surg Endosc. 1994;  8 19-24
  • 81 Ma C K, Gottlieb C, Haas P A. Diversion colitis: a clinicopathologic study of 21 cases.  Hum Pathol. 1990;  21 429-436
  • 82 Edwards C M, George B, Warren B. Diversion colitis-new light through old windows.  Histopathology. 1999;  34 1-5
  • 83 Lechner G L, Frank W, Jantsch H et al.. Lymphoid follicular hyperplasia in excluded colonic segments: a radiologic sign of diversion colitis.  Radiology. 1990;  176 135-136
  • 84 Roe A M, Warren B F, Brodribb A J, Brown C. Diversion colitis and involution of the defunctioned anorectum.  Gut. 1993;  34 382-385
  • 85 Warren B F, Shepherd N A. Diversion proctocolitis.  Histopathology. 1992;  21 91-93
  • 86 Geraghty J M, Talbot I C. Diversion colitis: histological features in the colon and rectum after defunctioning colostomy.  Gut. 1991;  32 1020-1023
  • 87 Komorowski R A. Histologic spectrum of diversion colitis.  Am J Surg Pathol. 1990;  14 548-554
  • 88 Murray F E, O'Brien M J, Birkett D H, Kennedy S M, LaMont J T. Diversion colitis. Pathologic findings in a resected sigmoid colon and rectum.  Gastroenterology. 1987;  93 1404-1408
  • 89 Warren B F, Shepherd N A, Bartolo D C, Bradfield J W. Pathology of the defunctioned rectum in ulcerative colitis.  Gut. 1993;  34 514-516
  • 90 Yeong M L, Bethwaite P B, Prasad J, Isbister W H. Lymphoid follicular hyperplasia-a distinctive feature of diversion colitis.  Histopathology. 1991;  19 55-61
  • 91 Roediger W E. Utilization of nutrients by isolated epithelial cells of the rat colon.  Gastroenterology. 1982;  83 424-429
  • 92 Neut C, Guillemot F, Colombel J F. Nitrate-reducing bacteria in diversion colitis: a clue to inflammation?.  Dig Dis Sci. 1997;  42 2577-2580
  • 93 Harig J M, Soergel K H, Komorowski R A, Wood C M. Treatment of diversion colitis with short-chain-fatty acid irrigation.  N Engl J Med. 1989;  320 23-28
  • 94 Guillemot F, Colombel J F, Neut C et al.. Treatment of diversion colitis by short-chain fatty acids. Prospective and double-blind study.  Dis Colon Rectum. 1991;  34 861-864
  • 95 Tripodi J, Gorcey S, Burakoff R. A case of diversion colitis treated with 5-aminosalicylic acid enemas.  Am J Gastroenterol. 1992;  87 645-647
  • 96 Gibson G R, Whitacre E B, Ricotti C A. Colitis induced by nonsteroidal anti-inflammatory drugs: report of four cases and review of the literature.  Arch Intern Med. 1992;  152 625-632
  • 97 Campieri M, Franchi L GA, Bazzocchi G et al.. Prostaglandins, indomethacin and ulcerative colitis [letter].  Gastroenterology. 1980;  89 1162-1188
  • 98 Kaufmann H J, Taubin H L. NSAID activate quiescent inflammatory bowel disease.  Ann Intern Med. 1987;  107 513-516
  • 99 Rampton D S, Sladen G GE. Relapse of ulcerative proctocolitis during treatment with NSAID.  Postgrad Med J. 1981;  57 297-299
  • 100 Rampton D S, McNeil N I, Sarner M. Analgesic ingestion and other factors preceding relapse in ulcerative colitis.  Gut. 1983;  24 187-189
  • 101 Coutrot S, Roland D, Barbier J, Marcq P VD, Alcalay M, Matuchansky C. Acute perforation of colonic diverticula associated with short term indomethacin.  Lancet. 1978;  2 1055-1056
  • 102 Wilson R G, Smith A N, McIntyre I MC. Complications of diverticular disease and nonsteroidal anti-inflammatory drugs: a prospective study.  Br J Surg. 1990;  77 1103-1104
  • 103 Campbell K, Steele R JC. Non-steroidal anti-inflammatory drugs and complicated diverticular disease: a case-control study.  Br J Surg. 1991;  78 190-191
  • 104 Foutch P G. Diverticular bleeding: are nonsteroidal anti-inflammatory drugs risk factors for hemorrhage and can colonoscopy predict outcome for patients?.  Am J Gastroenterol. 1995;  90 1779-1784
  • 105 Finkelstein J A, Jamieson C G. An association between anti-inflammatory medication and internal pelvic fistulas.  Dis Colon Rectum. 1987;  30 168-170
  • 106 Uribe A, Johansson C, Scezak P, Rubio C. Ulceration of the colon associated with naproxen and acetylsalicylic acid treatment.  Gastrointest Endosc. 1986;  32 242-244
  • 107 Carson J, Notis W M, Orris E S. Colonic ulceration and bleeding during diclofenac therapy.  , [letter] N Engl J Med. 1990;  323 135
  • 108 Bernsdorff K R, Agrawal R M, Brodmerkel G J. Nonsteroidal anti-inflammatory drugs: gastroduodenal injury and beyond.  Dig Dis. 1995;  13 251-266
  • 109 Bjarnason I, Hayllar J, Macpherson A J, Russell A S. Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans.  Gastroenterology. 1993;  104 1832-1847
  • 110 Faucheron J L, Parc R. Non-steroidal anti-inflammatory drug-induced colitis.  Int J Colorectal Dis. 1996;  11 99-101
  • 111 Gopal D V, Katon R M. Endoscopic balloon dilation of multiple NSAID-induced colonic strictures: case report and review of literature on NSAID-related colopathy.  Gastrointest Endosc. 1999;  50 120-123
  • 112 Jonas G, Mahone A, Murray J, Gertler S. Chemical colitis due to endoscope cleaning solutions: a mimic of pseudomembranous colitis.  Gastroenterology. 1988;  95 1403-1408
  • 113 Bilotta J J, Waye J D. Hydrogen peroxide enteritis: the “snow white” sign.  Gastrointest Endosc. 1989;  35 428-430
  • 114 Stein B L, Lamoreaux E, Miller M, Vasilevsky C A, Julien L, Gordon P H. Glutaraldehyde-induced colitis.  Can J Surg. 2001;  44 113-116
  • 115 Creteur V, Douglas D, Galante M, Margulis A R. Inflammatory colonic changes produced by contrast material.  Radiology. 1983;  147 77-78
  • 116 Pumphrey R E. Hydrogen peroxide proctitis.  Am J Surg. 1951;  1 60-62
  • 117 Meyer C T, Brand M, DeLuca V A, Spiro H M. Hydrogen peroxide colitis: a report of three patients.  J Clin Gastroenterol. 1981;  3 31-35
  • 118 Pike B F, Phillippi P J, Lawson E H. Soap colitis.  N Engl J Med. 1971;  285 217-219
  • 119 Kirchner S G, Buckspan G S, O'Neill J A, Page D L, Burko H. Detergent enema: a cause of caustic colitis.  Pediatr Radiol. 1977;  6 141-146
  • 120 Kim S K, Cho C, Levinsohn E M. Caustic colitis due to detergent enema.  AJR Am J Roentgenol. 1980;  134 397-398
  • 121 Berenguer J, Cabades F, Gras M D, Pertejo V, Rayon M, Sala T. Ischemic colitis attributable to a cleansing enema.  Hepatogastroenterology. 1981;  28 173-175
  • 122 Orchard J L, Lawson R. Severe colitis induced by soap enemas.  South Med J. 1986;  79 1459-1460
  • 123 Hardin R D, Tedesco F J. Colitis after Hibiclens enema.  J Clin Gastroenterol. 1986;  8 572-575
  • 124 da Fonseca J, Brito M J, Freitas J, Leal C. Acute colitis caused by caustic products.  Am J Gastroenterol. 1998;  93 2601-2602
  • 125 Munoz-Navas M, Garcia-Villarreal L. Caustic colitis due to formalin enema.  Gastrointest Endosc. 1992;  38 521-522
  • 126 Cappell M S, Simon T. Fulminant acute colitis following a self-administered hydrofluoric acid enema.  Am J Gastroenterol. 1993;  88 122-126
  • 127 Herrerias J M, Muniain M A, Sanchez S, Garrido M. Alcohol-induced colitis.  Endoscopy. 1983;  15 121-122
  • 128 Michopoulos S, Bouzakis H, Sotiropoulou M, Papaspyrou I, Tsibouris P, Kralios N. Colitis due to accidental alcohol enema.  Dig Dis Sci. 2000;  45 1188-1191
  • 129 Hill K L, Huang H, Katon R. Acute proctosigmoiditis caused by a dexamethasone mouthwash enema.  Gastrointest Endosc. 2005;  61 612-614
  • 130 Mian S R, McFadden K L, Valenstein P N, Shehab T M. Self-administered alcohol (vodka) enema causing severe colitis: case report and review.  Gastrointest Endosc. 2005;  61 922-926
  • 131 Cappell M S, Simon T. Colonic toxicity of administered medications and chemicals.  Am J Gastroenterol. 1993;  88 1684-1699
  • 132 Schapira M, Gerard R, Deltenre P, Henrion J, Ghilain J M. An unusual case for left sided colitis: hot water.  Acta Gastroenterol Belg. 1996;  59 220-221
  • 133 Young W S. Herbal-enema colitis and stricture.  Br J Radiol. 1980;  53 248-249
  • 134 Madisch A, Wiedbrauck F, Marquard F, Stolte M, Hotz J. 5-Fluorouracil-induced colitis-a review based upon consideration of 6 cases.  Z Gastroenterol. 2002;  40 59-66
  • 135 Akay S, Ozütemiz O, Doganavsargil B. Severe colitis after administration of UFT chemotherapy for temporal bone carcinoma.  Expert Opin Drug Saf. 2004;  3 89-92
  • 136 Sadamoto Y, Ueda T, Matsumoto M et al.. A case of drug-induced colitis complicating the administration of hydroxycarbamide.  Endoscopy. 2002;  34 511
  • 137 Murphy E A, Morris A J, Walker E, Lee F D, Sturrock R D. Cyclosporine A induced colitis and acquired selective IgA deficiency in a patient with juvenile chronic arthritis.  J Rheumatol. 1993;  20 1397-1398
  • 138 Constantopoulos A. Colitis induced by interaction of cyclosporine A and non-steroidal anti-inflammatory drugs.  Pediatr Int. 1999;  41 184-186
  • 139 Randall C W, Taboada C M, Kimble J. Mesalamine induces clinical and histological remission in patients with microscopic colitis.  Gastroenterology. 2003;  124(Suppl 1) A63-A64
  • 140 Weidner N, Smith J, Pattee B. Sulfasalazine in treatment of collagenous colitis. Case report and review of the literature.  Am J Med. 1984;  77 162-166
  • 141 Rokkas T, Filipe M I, Sladen G E. Collagenous colitis with rapid response to sulphasalazine.  Postgrad Med J. 1988;  64 74-76
  • 142 Zins B J, Sandborn W J, Tremaine W J. Collagenous and lymphocytic colitis: subject review and therapeutic alternatives.  Am J Gastroenterol. 1995;  90 1394-1400
  • 143 Sloth H, Bisgaard C, Grove A. Collagenous colitis: a prospective trial of prednisolone in six patients.  J Intern Med. 1991;  229 443-446
  • 144 Fine K D, Lee E L. Efficacy of open-label bismuth subsalicylate for the treatment of microscopic colitis.  Gastroenterology. 1998;  114 29-36
  • 145 Bohr J, Olesen M, Tysk C, Jarnerot G. Budesonide and bismuth in microscopic colitis.  Gut. 1999;  45 A202
  • 146 Girard D E, Keeffe E B. Therapy for collagenous colitis.  Ann Intern Med. 1987;  106 909
  • 147 Vennamaneni S R, Bonner G F. Use of azathioprine or 6-mercaptopurine for treatment of steroid-dependent lymphocytic and collagenous colitis.  Am J Gastroenterol. 2001;  96 2798-2799
  • 148 Pardi D S, Loftus Jr E V, Tremaine W J, Sandborn W J. Treatment of refractory microscopic colitis with azathioprine and 6-mercaptopurine.  Gastroenterology. 2001;  120 1483-1484
  • 149 Bhullar D S, Tymms K E, Hillman L, Jain S. Treatment of collagenous colitis with methotrexate.  Aust N Z J Med. 1996;  26 114
  • 150 Tromm A, Niewerth U, Khoury M et al.. The probiotic E. coli strain Nissle 1917 for the treatment of collagenous colitis: first results of an open-label trial.  Z Gastroenterol. 2004;  42 365-369
  • 151 Münch A, Söderholm J D, Wallon C, Ost A, Olaison G, Ström M. Dynamics of mucosal permeability and inflammation in collagenous colitis before, during, and after loop ileostomy.  Gut. 2005;  54 1126-1128
  • 152 Munck L K, Kjeldsen J, Philipsen E, Fischer Hansen B. Incomplete remission with short-term prednisolone treatment in collagenous colitis: a randomized study.  Scand J Gastroenterol. 2003;  38 606-610
  • 153 Miehlke S, Heymer P, Bethke B et al.. Budesonide treatment for collagenous colitis: a randomized, double-blind, placebo-controlled, multicenter trial.  Gastroenterology. 2002;  123 978-984
  • 154 Bonderup O K, Hansen J B, Birket-Smith L, Vestergaard V, Teglbjaerg P S, Fallingborg J. Budesonide treatment of collagenous colitis: a randomised, double-blind, placebo controlled trial with morphometric analysis.  Gut. 2003;  52 248-251
  • 155 Baert F, Schmit A, D'Haens G et al.. Budesonide in collagenous colitis: a double-blind placebo-controlled trial with histologic follow-up.  Gastroenterology. 2002;  122 20-25

Amy J ThorsenM.D. 

Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota

393 Dunlap St. North, #500, St. Paul, MN 55104

Email: athorsen@colonrectal.org

    >