Source: Surgery  |  Posted 9 years ago

The degree of lamina propria inflammation in patients with collagenous colitis can be used as a histological predictor to guide treatment.

This was one of the findings of a study of 62 predominantly female patients with collagenous colitis (median age 58 years, range 20-85 years). The study was carried out by Dr. A. Abdo and colleagues at St. Paul's Hospital in Vancouver, Canada.

Patients came from three tertiary-care medical centres and were divided into three groups based on their response to therapy: spontaneous recovery or response to antidiarrheal agents alone; response to 5-ASA agents; and response to corticosteroids after failure of anti-diarrheal agents and 5-ASA.

The degree of lamina propria inflammation was the only histological parameter that significantly differed in the three response groups (p=0.007). Said Dr. Abdo, "Patients who required corticosteroids had greater inflammation."

In addition, the age at presentation and use of non-steroidal anti-inflammatories (NSAIDs) significantly differed between groups. "In the anti-diarrheal group, patients tended to be more elderly, and in the corticosteroid group, more patients were on NSAIDs", commented Dr. Abdo.

The fact that the patients who were taking NSAIDs were more likely to need corticosteroid therapy probably reflected more severe disease.