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Genetic and Rare Diseases Information Center (GARD)

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Collagenous colitis

Other Names for this Disease
  • Microscopic colitis, collagenous type
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Your Question

I have been able to get control of the diarrhea which is the most common symptom. I have so much flatulence, bloating, and intestinal noise that I no longer can keep appointments. Is this a common symptom with this disease? I cannot take any meds as they can cause severe pain in the gut. Anything I can do? I now live a very isolated life with very little contact with people.

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What are the signs and symptoms of collagenous colitis?

All individuals with collagenous colitis experience chronic, watery, non-bloody diarrhea which is what typically prompts individuals to seek medical attention.[1][2] Onset of diarrhea may occur gradually over time or may be sudden and abrupt.[3] Episodes of diarrhea may be intermittent and can occur over weeks, months or years.[3]

Other signs and symptoms that commonly occur in affected individuals include abdominal pain or cramping; flatulence; bloating; and weight loss.[2][3] Incontinence, urgency, nausea, vomiting and fatigue have also been reported.[3]

Some individuals with collagenous colitis experience spontaneous remission even without treatment; however, relapses can occur.[3]
Last updated: 6/21/2013

How might collagenous colitis be treated?

Treatment for collagenous colitis varies depending on the symptoms and severity in each affected individual. In some cases the condition may resolve on its own (spontaneous remission), although most people continue to have ongoing or occasional diarrhea.[4]

Dietary changes are usually tried first to alleviate symptoms. These changes may include a reduced-fat diet, eliminating foods that contain caffeine and lactose, and avoiding over-the-counter pain relievers such as ibuprofen or aspirin. If these changes alone are not enough, medications can be used to help control symptoms.[4] However, the response rate to various types of medication reportedly varies.[1] Prescription anti-inflammatory medications such as mesalamine and sulfasalazine may help reduce swelling. Steroids including budesonide and prednisone can be used reduce inflammation, but they are usually only used to control sudden attacks of diarrhea. Long-term use of steroids is typically avoided because of unwanted side effects. Anti-diarrheal medications such as bismuth subsalicylate, diphenoxylate with atropine, and loperamide can offer short-term relief. Immunosuppressive agents such as azathioprine help to reduce inflammation but are rarely needed. In extreme cases where the condition does not respond to medications, surgery to remove all or part of the colon may be necessary. However, surgery is rarely recommended.[4]
Last updated: 6/21/2013