Endoscopy 2025; 57(S 02): S520
DOI: 10.1055/s-0045-1806348
Abstracts | ESGE Days 2025
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Collagenous Colitis: A case report

Authors

  • E Pengili

    1   REGIONAL MEMORIAL HOSPITAL, Fier, Albania

  • A Bruci

    1   REGIONAL MEMORIAL HOSPITAL, Fier, Albania

  • B Baş

    2   Near East University Library, Nicosia, Cyprus
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Collagenous colitis (CC) is known as a cause of chronic watery diarrhea, characterized by normal colonic mucosa, and abnormal histologic hallmarks. We report a case of a 33-year-old male who presented with postprandial, watery diarrhea, often alternated with constipation, arthralgia, fatigue, and weight loss, lasting for a year. Prior to these symptoms, patient referred that had persistent bilateral submandibular lymph nodes, aphtous ulcers and spondylitis where infectious and autoimmune causes were excluded. First ileocolonoscopy realized 6 months ago, was normal. Blood tests, including infection parameters and autoimmune profiles, revealed nearly normal results, expect for low level of vitamin C and folic acid. Stool examination showed no specific findings. Cervical ultrasound showed reactive, bilateral submandibular lymphadenopathy up to 34x11mm. Upper endoscopy and biopsies revealed gastritis, excluded celiac disease. Second colonoscopy revealed normal looking mucosa, but biopsies that were taken in all segments of colon, showed a thickened collagen band under the surface epithelium. The treatment with budesonide achieved symptomatic improvement. Discussion Although CC is mostly found in middle aged women, we report a case of a 33 year old male. Sometimes disorders, such as arthritis, spondylitis, thyroiditis and skin disorders, dominate the clinical course which it delates the diagnosis. The persistence to obtain adequate colonic endoscopic biopsies was crucial for a correct diagnosis and treatment.This case highlights the difficulties in diagnosis of collagenous colitis. We emphasize obtaining multiple random colonic biopsies in cases of refractory diarrhea, without any specific cause [1] [2] [3].



Publication History

Article published online:
27 March 2025

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