Diagnosing collagenous colitis: does it make a difference?

Collagenous colitis is part of the spectrum of disorders known as microscopic colitis, which also include lymphocytic colitis and a mixed disorder with both a collagen band present and also intra-epithelial lymphocytes. Collagenous colitis appears to be caused by mucosal injury from toxins in the faecal stream. The collagen band is a result of the underlying inflammatory process and not the cause of symptoms. The diagnosis is based on colonic mucosal pathology and a compatible clinical presentation. Treatment is empiric and ranges from no therapy, to anti-inflammatory or anti-secretory agents, to diverting ileostomy.