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Curt Tysk - One of the best experts on this subject based on the ideXlab platform.
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health related quality of life is impaired in active Collagenous Colitis
Digestive and Liver Disease, 2011Co-Authors: Henrik Hjortswang, Johan Bohr, Curt Tysk, Yesuf Taha, Cecilia Benoni, Anders Kilander, Lina Vigren, Lasse Larsson, Magnus StromAbstract:Objectives: The characteristic clinical symptoms of Collagenous Colitis are non-bloody diarrhoea, urgency and abdominal pain. Treatment is aimed at reducing the symptom burden and the disease impact on patients' health-related quality of life. The objective of this study was to analyse health-related quality of life in patients with Collagenous Colitis. Methods: In a cross-sectional, postal HRQL survey, 116 patients with Collagenous Colitis at four Swedish hospitals completed four health-related quality of life questionnaires, two disease-specific (Inflammatory Bowel Disease Questionnaire and Rating Form of IBD Patient Concerns), and two generic (Short Form 36, SF-36, and Psychological General Well-Being, PGWB), and a one-week symptom diary. Demographic and disease-related data were collected. Results for the Collagenous Colitis population were compared with a background population controlled for age and gender (n = 8931). Results: Compared with a Swedish background population, patients with Collagenous Colitis scored significantly worse in all Short Form 36 dimensions (p < 0.01), except physical function. Patients with active disease scored worse health-related quality of life than patients in remission. Co-existing disease had an impact on health-related quality of life measured with the generic measures. Lower education level and shorter disease duration were associated with decreased well-being. Conclusion: Health-related quality of life was impaired in patients with Collagenous Colitis compared with a background population. Disease activity is the most important factor associated with impairment of health-related quality of life. Patients in remission have a health-related quality of life similar to a background population. (C) 2010 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
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Yersinia Species in Collagenous Colitis: A Serologic Study
Scandinavian Journal of Gastroenterology, 2009Co-Authors: Johan Bohr, R. Nordfelth, Gunnar Järnerot, Curt TyskAbstract:Background: The etiology of Collagenous Colitis is unknown. An infectious cause seems a possibility, and in a recent report three out of six patients with Collagenous Colitis were shown to have had an infection with Yersinia enterocolitica. The aim was to investigate the occurrence of Yersinia antibodies in Collagenous Colitis. Methods: Sera from 32 Collagenous Colitis patients and 17 healthy controls were analysed for antibodies against Yersinia virulence proteins. Results: Collagenous Colitis patients had Yersinia antibodies more often than the controls, 9 having a positive and 4 an intermediate antibody score of the 32 patients. In comparison, 1 out of 17 controls had a positive and 2 an intermediate antibody score, which represents a strong, although not significant, trend ( P = 0.078). Conclusion: The data showed that Yersinia antibodies are more common in Collagenous Colitis patients than in healthy controls. In some cases, Yersinia might have been the triggering event in the development of collagen...
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colonic mucosal tears in Collagenous Colitis
Scandinavian Journal of Gastroenterology, 2006Co-Authors: Anna Wickbom, Magnus Lindqvist, Johan Bohr, Jan Bergman, Sune Eriksson, Curt TyskAbstract:In general, the colonic mucosa is macroscopically normal in Collagenous Colitis, although minor, non-specific abnormalities may be found. Significant endoscopic abnormalities, “mucosal tears” representing longitudinal mucosal lacerations, have been reported in a few patients with Collagenous Colitis. We report the cases of three women with Collagenous Colitis and mucosal tears detected at the index colonoscopy in order to illustrate the endoscopic characteristics and review the literature. Including the present cases, a total of 12 patients with mucosal tears and Collagenous Colitis have been reported. In 10 patients, the mucosal lacerations involved the ascending or the transverse colon. Three of the 12 patients had a colonic perforation immediately after the colonoscopy. The colonoscopist should be aware that the risk of perforation is likely to be increased when mucosal tears are present.
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colonic perforation in Collagenous Colitis an unusual complication
European Journal of Gastroenterology & Hepatology, 2005Co-Authors: Johan Bohr, Sune Eriksson, Larsgoran Larsson, G Jarnerot, Curt TyskAbstract:: Collagenous Colitis is generally regarded as a benign disease with few serious complications. We report two women with Collagenous Colitis who presented with colonic perforation, one spontaneously and one 7 days after a barium enema, and a review of the literature. Including the present cases, 13 patients with Collagenous Colitis and colonic perforation have been reported, in two patients spontaneously and in 11 patients after a colonoscopy or barium enema. All were operated on except one patient who recovered after medical treatment. The pathogenesis of this complication is unknown. We propose that there might be a connection between mucosal tears and colonic perforation in Collagenous Colitis.
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autoantibodies and immunoglobulins in Collagenous Colitis
Gut, 1996Co-Authors: Johan Bohr, Curt Tysk, P Yang, Dan Danielsson, G JarnerotAbstract:BACKGROUND: The aetiology and pathogenesis of Collagenous Colitis are unknown. Autoimmunity has been suggested, but no serological findings have supported such a theory. AIMS AND METHODS: Serum from 38 Collagenous Colitis patients and 38 matched healthy controls was analysed for autoantibodies--that is, antinuclear antibodies, antineutrophil cytoplasmic antibodies, smooth muscle and mitochondrial antibodies, rheumatoid factor and antibodies to thyroglobulin and microsomal antigen, together with antibodies to endomysium, gliadin, and cardiolipin. The serum values of IgA, IgG, IgM, and IgG-subclasses, and complement factors C3 and C4 were also determined. RESULTS: In patients with Collagenous Colitis the mean value of IgM was significantly increased 2.5 g/l (95% CI; 1.9, 3.2) compared with 1.4 g/l (95% CI; 1.2, 1.7) in controls (p = 0.002). Antinuclear antibodies occurred in nine of 38 patients compared with three of 38 controls, this difference was not statistically significant (p = 0.11). The results of all other immunoglobulins, complement factors, and specific antibodies showed no statistical difference between patients and controls. CONCLUSIONS: No firm evidence for an autoimmune genesis in Collagenous Colitis is found in this study, although the findings of a positive ANA-titre in some patients and an increased IgM level might give some support for this hypothesis.
William J Tremaine - One of the best experts on this subject based on the ideXlab platform.
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Collagenous Colitis and lymphocytic Colitis
Journal of Clinical Gastroenterology, 2000Co-Authors: William J TremaineAbstract:AbstractThe most recently recognized and least understood forms of inflammatory bowel disease are two types of idiopathic microscopic Colitis-Collagenous Colitis and lymphocytic Colitis. These disorders share many clinical and histologic features, but they have a few notable differences. Whether the
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Collagenous Colitis mucosal biopsies and association with fecal leukocytes
Mayo Clinic Proceedings, 1995Co-Authors: Bradley J Zins, William J Tremaine, Herschel A CarpenterAbstract:Objective To determine the frequency of patchy colonic involvement, fecal leukocytosis, and association with celiac sprue in a large cohort of patients with Collagenous Colitis. Design We conducted a retrospective review of the medical records of 172 consecutive Mayo Clinic patients in whom Collagenous Colitis had been diagnosed between 1982 and 1993. Methods For each of the 172 patients, the medical record was reviewed to determine the frequency of (1) fecal leukocytosis; (2) characteristic histologic findings in the rectum and the sigmoid, descending, and ascending colon; and (3) small bowel biopsy findings consistent with celiac sprue. Results The presence of fecal leukocytes was noted in 64 of 116 patients (55%) who had undergone assessment for fecal leukocytosis. On analysis of histologic findings, 113 of 123 rectal, 116 of 121 sigmoid, and 68 of 70 descending colon biopsy specimens were diagnostic of Collagenous Colitis. Small bowel biopsies were performed in 45 patients who did not have a history of small intestinal disease: 1 had celiac sprue and 44 had normal findings. Two other patients had previously diagnosed celiac sprue. Conclusion The finding of fecal leukocytes in 55% of patients with Collagenous Colitis confirms the inflammatory basis of this disease. Biopsy specimens obtained by flexible sigmoidoscopy seem sufficient to establish the diagnosis in most patients, and colonoscopic biopsy of the more proximal area of the colon is usually unnecessary. Celiac sprue infrequently accompanies Collagenous Colitis; thus, routine small bowel biopsy is not warranted.
Johan Bohr - One of the best experts on this subject based on the ideXlab platform.
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health related quality of life is impaired in active Collagenous Colitis
Digestive and Liver Disease, 2011Co-Authors: Henrik Hjortswang, Johan Bohr, Curt Tysk, Yesuf Taha, Cecilia Benoni, Anders Kilander, Lina Vigren, Lasse Larsson, Magnus StromAbstract:Objectives: The characteristic clinical symptoms of Collagenous Colitis are non-bloody diarrhoea, urgency and abdominal pain. Treatment is aimed at reducing the symptom burden and the disease impact on patients' health-related quality of life. The objective of this study was to analyse health-related quality of life in patients with Collagenous Colitis. Methods: In a cross-sectional, postal HRQL survey, 116 patients with Collagenous Colitis at four Swedish hospitals completed four health-related quality of life questionnaires, two disease-specific (Inflammatory Bowel Disease Questionnaire and Rating Form of IBD Patient Concerns), and two generic (Short Form 36, SF-36, and Psychological General Well-Being, PGWB), and a one-week symptom diary. Demographic and disease-related data were collected. Results for the Collagenous Colitis population were compared with a background population controlled for age and gender (n = 8931). Results: Compared with a Swedish background population, patients with Collagenous Colitis scored significantly worse in all Short Form 36 dimensions (p < 0.01), except physical function. Patients with active disease scored worse health-related quality of life than patients in remission. Co-existing disease had an impact on health-related quality of life measured with the generic measures. Lower education level and shorter disease duration were associated with decreased well-being. Conclusion: Health-related quality of life was impaired in patients with Collagenous Colitis compared with a background population. Disease activity is the most important factor associated with impairment of health-related quality of life. Patients in remission have a health-related quality of life similar to a background population. (C) 2010 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
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Yersinia Species in Collagenous Colitis: A Serologic Study
Scandinavian Journal of Gastroenterology, 2009Co-Authors: Johan Bohr, R. Nordfelth, Gunnar Järnerot, Curt TyskAbstract:Background: The etiology of Collagenous Colitis is unknown. An infectious cause seems a possibility, and in a recent report three out of six patients with Collagenous Colitis were shown to have had an infection with Yersinia enterocolitica. The aim was to investigate the occurrence of Yersinia antibodies in Collagenous Colitis. Methods: Sera from 32 Collagenous Colitis patients and 17 healthy controls were analysed for antibodies against Yersinia virulence proteins. Results: Collagenous Colitis patients had Yersinia antibodies more often than the controls, 9 having a positive and 4 an intermediate antibody score of the 32 patients. In comparison, 1 out of 17 controls had a positive and 2 an intermediate antibody score, which represents a strong, although not significant, trend ( P = 0.078). Conclusion: The data showed that Yersinia antibodies are more common in Collagenous Colitis patients than in healthy controls. In some cases, Yersinia might have been the triggering event in the development of collagen...
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colonic mucosal tears in Collagenous Colitis
Scandinavian Journal of Gastroenterology, 2006Co-Authors: Anna Wickbom, Magnus Lindqvist, Johan Bohr, Jan Bergman, Sune Eriksson, Curt TyskAbstract:In general, the colonic mucosa is macroscopically normal in Collagenous Colitis, although minor, non-specific abnormalities may be found. Significant endoscopic abnormalities, “mucosal tears” representing longitudinal mucosal lacerations, have been reported in a few patients with Collagenous Colitis. We report the cases of three women with Collagenous Colitis and mucosal tears detected at the index colonoscopy in order to illustrate the endoscopic characteristics and review the literature. Including the present cases, a total of 12 patients with mucosal tears and Collagenous Colitis have been reported. In 10 patients, the mucosal lacerations involved the ascending or the transverse colon. Three of the 12 patients had a colonic perforation immediately after the colonoscopy. The colonoscopist should be aware that the risk of perforation is likely to be increased when mucosal tears are present.
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colonic perforation in Collagenous Colitis an unusual complication
European Journal of Gastroenterology & Hepatology, 2005Co-Authors: Johan Bohr, Sune Eriksson, Larsgoran Larsson, G Jarnerot, Curt TyskAbstract:: Collagenous Colitis is generally regarded as a benign disease with few serious complications. We report two women with Collagenous Colitis who presented with colonic perforation, one spontaneously and one 7 days after a barium enema, and a review of the literature. Including the present cases, 13 patients with Collagenous Colitis and colonic perforation have been reported, in two patients spontaneously and in 11 patients after a colonoscopy or barium enema. All were operated on except one patient who recovered after medical treatment. The pathogenesis of this complication is unknown. We propose that there might be a connection between mucosal tears and colonic perforation in Collagenous Colitis.
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autoantibodies and immunoglobulins in Collagenous Colitis
Gut, 1996Co-Authors: Johan Bohr, Curt Tysk, P Yang, Dan Danielsson, G JarnerotAbstract:BACKGROUND: The aetiology and pathogenesis of Collagenous Colitis are unknown. Autoimmunity has been suggested, but no serological findings have supported such a theory. AIMS AND METHODS: Serum from 38 Collagenous Colitis patients and 38 matched healthy controls was analysed for autoantibodies--that is, antinuclear antibodies, antineutrophil cytoplasmic antibodies, smooth muscle and mitochondrial antibodies, rheumatoid factor and antibodies to thyroglobulin and microsomal antigen, together with antibodies to endomysium, gliadin, and cardiolipin. The serum values of IgA, IgG, IgM, and IgG-subclasses, and complement factors C3 and C4 were also determined. RESULTS: In patients with Collagenous Colitis the mean value of IgM was significantly increased 2.5 g/l (95% CI; 1.9, 3.2) compared with 1.4 g/l (95% CI; 1.2, 1.7) in controls (p = 0.002). Antinuclear antibodies occurred in nine of 38 patients compared with three of 38 controls, this difference was not statistically significant (p = 0.11). The results of all other immunoglobulins, complement factors, and specific antibodies showed no statistical difference between patients and controls. CONCLUSIONS: No firm evidence for an autoimmune genesis in Collagenous Colitis is found in this study, although the findings of a positive ANA-titre in some patients and an increased IgM level might give some support for this hypothesis.
R S Reyes - One of the best experts on this subject based on the ideXlab platform.
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meta analysis budesonide treatment for Collagenous Colitis
Alimentary Pharmacology & Therapeutics, 2004Co-Authors: B Feyen, G C Wall, E P Finnerty, J E Dewitt, R S ReyesAbstract:Summary Background : Collagenous Colitis is typified by chronic watery diarrhoea and characteristic histological alterations of the colonic mucosa without endoscopic abnormalities. Budesonide, a corticosteroid with high first-pass metabolism has been examined in Collagenous Colitis, but studies to date have had small numbers, and relatively low statistical power. Aim : A meta-analysis of existing published trials was undertaken to evaluate the treatment effect of budesonide in Collagenous Colitis. Methods : All pertinent literature sources were searched for published reports in English of budesonide use in Collagenous Colitis. MEDLINE and EMBASE databases were reviewed, as well as bibliographies from published articles and available abstracts from relevant meetings. Literature that met prespecified criteria was selected for the meta-analysis. Results : Three trials were included in the meta-analysis. Budesonide significantly decreased stool frequency (budesonide vs. placebo OR: 20.1, 95% CI: 7.0–57.5, P < 0.0001). In general, budesonide treatment was well-tolerated. Conclusions : Budesonide is clinically effective short-term in Collagenous Colitis, and seems to be relatively well-tolerated. Clinicians can consider this drug as a reasonable option for patients with this disorder.
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Meta-analysis: budesonide treatment for Collagenous Colitis.
Alimentary Pharmacology & Therapeutics, 2004Co-Authors: B Feyen, G C Wall, E P Finnerty, J E Dewitt, R S ReyesAbstract:Summary Background : Collagenous Colitis is typified by chronic watery diarrhoea and characteristic histological alterations of the colonic mucosa without endoscopic abnormalities. Budesonide, a corticosteroid with high first-pass metabolism has been examined in Collagenous Colitis, but studies to date have had small numbers, and relatively low statistical power. Aim : A meta-analysis of existing published trials was undertaken to evaluate the treatment effect of budesonide in Collagenous Colitis. Methods : All pertinent literature sources were searched for published reports in English of budesonide use in Collagenous Colitis. MEDLINE and EMBASE databases were reviewed, as well as bibliographies from published articles and available abstracts from relevant meetings. Literature that met prespecified criteria was selected for the meta-analysis. Results : Three trials were included in the meta-analysis. Budesonide significantly decreased stool frequency (budesonide vs. placebo OR: 20.1, 95% CI: 7.0–57.5, P
Karel Geboes - One of the best experts on this subject based on the ideXlab platform.
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lymphocytic Colitis a distinct clinical entity a clinicopathological confrontation of lymphocytic and Collagenous Colitis
Gut, 1999Co-Authors: Filip Baert, Geert Dhaens, S Naegels, J Holvoet, Edouard Louis, Martine Devos, K Wouters, P. Hoang, F Dheygere, Karel GeboesAbstract:Background and aims-It is not known whether lymphocytic Colitis and Collagenous Colitis represent different clinical entities or constitute part of a spectrum of disease. Methods-Detailed clinical features and histological findings were compared in a large series of patients with confirmed lymphocytic and Collagenous Colitis. Results-Histological diagnosis was confirmed in 96 patients with Collagenous Colitis and 80 with lymphocytic Colitis. Twenty eight per cent of patients with Collagenous Colitis and 26% of patients with lymphocytic Colitis had overlapping but less pronounced histological features. Both groups were equal in terms of age, use of aspirin and non-steroidal antiinflammatory drugs, associated autoimmune conditions, arthritis, diarrhoea, and abdominal pain. The male:female ratio was 27:73 for Collagenous Colitis and 45:55 for lymphocytic Colitis (p=0.013). Twenty five per cent of patients with Collagenous Colitis compared with 14% of patients with lymphocytic Colitis were active smokers; only 8.3% of patients with Collagenous Colitis had stopped smoking compared with 23% of patients with lymphocytic Colitis (p=0.013). Drug induced disease was suspected for ticlopidine (two Collagenous Colitis, four lymphocytic Colitis) and flutamide (four lymphocytic Colitis). Mean duration of symptoms before diagnosis was two months for lymphocytic Colitis and four months for Collagenous Colitis. Overall prognosis was generally mild; 84% of patients with lymphocytic Colitis and 74% of patients with Collagenous Colitis reported resolution or significant improvement (p=0.033). Conclusions-Collagenous and lymphocytic Colitis are similar but not identical. Patients with lymphocytic Colitis present somewhat earlier and are less likely to be active smokers. Symptoms are milder and more likely to disappear in lymphocytic Colitis, Ticlopidine and flutamide should be added to the list of drugs inducing Colitis.