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Long-term course in collagenous colitis and the impact of bile acid malabsorption and bile acid sequestrants on histopathology and clinical features.

AbstractBACKGROUND:
Bile acid malabsorption is common in collagenous colitis, although long-term follow-up data on the impact of bile acids are limited. The aim was to study whether bile acid malabsorption is a permanent finding, with an impact on histopathology and clinical features in collagenous colitis.
METHODS:
The objective was to reinvestigate 27 patients with collagenous colitis > or = 3 years after index investigation. The clinical course was evaluated by means of an interview, a review of the hospital records and registration of symptoms over a period of 7 days. The patients were invited to undergo a repeat colonoscopy and 75SeHCAT measurement. Initial and follow-up data and 75SeHCAT values from 29 controls were compared.
RESULTS:
The median follow-up time was 4.2 (range 3-5.3) years. Twenty-two patients underwent a repeat 75SeHCAT test, 23 patients a colonoscopy and in 25 patients the clinical course could be evaluated. The 75SeHCAT values were abnormal in 32% at follow-up versus 44% at index, and the median retention value was 19% (range 2-69) versus 12% (range 0.5-41) (P = 0.024) although lower than in the control groups figure of 38% (range 8-91) (P < 0.005). Histopathology had improved independently of bile acid malabsorption, gender, smoking and autoimmune disease at follow-up. Four were normalized. Patients on bile acid binders had no significant change of histopathology. Four patients had recovered, seven displayed an intermittent course and 14 had continuous diarrhoea.
CONCLUSIONS:
Collagenous colitis and bile acid malabsorption seem to be associated yet independent disorders. The histopathology improves during the long-term course although only a few patients resolve.
AuthorsK A Ung, A Kilander, O Nilsson, H Abrahamsson
JournalScandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 36 Issue 6 Pg. 601-9 (Jun 2001) ISSN: 0036-5521 [Print] England
PMID11424318 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Bile Acids and Salts
  • Selenium Radioisotopes
  • Cholestyramine Resin
  • Taurocholic Acid
  • 23-seleno-25-homotaurocholic acid
Topics
  • Bile Acids and Salts (metabolism)
  • Cholestyramine Resin (therapeutic use)
  • Colitis (metabolism, pathology)
  • Colon (pathology)
  • Colonoscopy
  • Female
  • Follow-Up Studies
  • Humans
  • Ileum (pathology)
  • Malabsorption Syndromes (drug therapy, metabolism, pathology)
  • Male
  • Middle Aged
  • Selenium Radioisotopes
  • Taurocholic Acid (analogs & derivatives)
  • Time Factors

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