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Macroscopic findings in collagenous colitis: a multi-center, retrospective,
observational cohort study
#MMPMID28469361
Koulaouzidis A
; Yung DE
; Nemeth A
; Sjöberg K
; Giannakou A
; Qureshi R
; Bartzis L
; McNeill M
; Johansson GW
; Lucendo AJ
; Fineron P
; Trimble KC
; Saeed A
; Plevris JN
; Toth E
Ann Gastroenterol
2017[]; 30
(3
): 309-314
PMID28469361
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BACKGROUND: Collagenous colitis (CC) is by definition a histological diagnosis.
However, colonoscopy often reveals characteristic endoscopic findings. The aim of
this study was to evaluate the frequency and type of endoscopic findings in
patients diagnosed with CC in 4 participating centers. METHODS: This was a
retrospective study; the databases of 2 university hospitals in Edinburgh
(Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso
(Spain) and Gateshead (England) were interrogated for patients diagnosed with CC
between May 2008 and August 2013. Endoscopy reports and images were retrieved and
reviewed; data on lesions, sedation, bowel preparation and endoscopist experience
were abstracted. Categorical data are reported as mean±SD. Fischer's exact,
chi-square and t (unpaired) tests were used to compare datasets. A two-tailed
P-value of <0.05 was considered statistically significant. RESULTS: 607 patients
(149 male, mean age 66.9±12.25 years) were diagnosed with CC. A total of 108/607
(17.8%) patients had one or more suggestive endoscopy findings: i.e., mucosal
erythema/edema, 91/607 (15%); linear colonic mucosal defects, 12/607 (2%); or
mucosal scarring, 5/607 (0.82%). For colonic mucosa erythema, there was no
difference in the odds of finding erythema with the use of different bowel
preparation methods (P=0.997). For colonic mucosal defects there was some
evidence (P=0.005) that patients colonoscoped by experienced endoscopists had 87%
less odds of developing such defects. Moreover, there was evidence that analgesia
reduced the odds of developing mucosal defects by 84%. CONCLUSION: A significant
minority of patients with CC have endoscopic findings in colonoscopy. The
description of such findings appears to be related to the endoscopist's
experience.
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