“A game of patience : Collagenous colitis – rare of cause of chronic diarrhea”

After surfing the internet if you have landed on this page I would say that the diarrhea has been quite bothersome for you and we hope to provide you with some answers.

The chronicity of diarrhea is arbitrarily defined based on the length of weeks.

  • Acute diarrhea < 4 weeks

  • Chroni diarrhea > 4 weeks

A wide range of problems can cause chronic diarrhea;

IBS is the most common cause in most of the practices. You know this if you have it – since most of your life diarrhea and/or constipation with abdominal cramps has been a major issue.

Inflammatory bowel disease — or referred to as “Colitis” or commonly labelled Crohn’s disease and ulcerative colitis (UC).

Some uncommon forms of IBD are Collagenous, Microscopic colitis or Lymphocytic colitis.

I recently had a case of Collagenous colitis that tested my belief.

Patient presented with watery diarrhea that started fairly recently without bleeding and pain. It disrupted her lifestyle. The diagnosis was made easily when biopsies from colonoscopy revealed a prominent layer of collagen under the mucosa. I explained her that this extra layer made the mucosa impervious and decrease water absorption leading to diarrhea. I sensed victory only to be disappointed by her persistent diarrhea and lack of response to medication initially. It was only after exhausting the first few options that we finally got the breakthrough as you get to read below.

Collagenous colitis

I started her on pepto-bismol which made her diarrhea ‘black’ in color as expected. Because of lack of response she was quickly put on Asacol – a common medication used for colitis (UC and Crohn’s disease). However she remained miserable and wet.

After discussing the side effect profile I put her on Prednisone – steroids. She had a vigorous response with resolution of diarrhea. I have since transitioned her off and maintained her on Asacol without diarrhea.

It was only after at least 4 weeks that we could control her diarrhea. To her and us it felt like a whole year had passed. Good news – both of us remained patient to enforce trust in our believes.

Please call us : 281-557-25727.

If you wish to see me, please schedule a visit at one of the locations : 281-557-2527

  • Clear Lake Office (Wesbter)
    1015 Medical Center Blvd
    Suite 1300, Webster, TX 77598
    Phone: (281) 557-2527
  • Satellite Office 2
    7111 Medical Center Drive
    2nd Floor
    Texas City, TX 77591

I would be willing to talk to you over the phone and help you guide towards better GI health.

If I am not available please leave your name and phone number and I will call you later.

Dr. Adi Malhotra

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