Special forms of chronic colitis

Collagen Colitis

Collagen colitis is an inflammatory disease of the large intestine, characterized by intensive development of collagen in the mucous membrane.

Women are more often ill (10 times more often than men), mostly aged 45-55 years. The etiology of the disease is unknown. In the pathogenesis, the immunoinflammatory process is important.

The main signs of the disease are diarrhea, pain, mainly in the right side of the colon (the rectum may not be involved in the inflammatory process). The picture of inflammation of the mucous membrane of the colon is revealed endoscopically.

In the formulation of the diagnosis, a leading role belongs to the study of the biopsy. The biopsy specimen reveals a wide continuous band of collagen 10-15 μm long and longer under the intergluteal surface of the epithelium. Characteristic is also an increase in the number of monocytes, lymphocytes, fatty, plasma cells and eosinophils in the lamina proper and an increase in the number of interepithelial lymphocytes in the superficial epithelium. There are reports of the development of Crohn's disease in patients with collagen colitis. Cases of ulcerative colitis development following collagen are described.

Eosinophilic enterocolitis (or gastroenteritis)

Eosinophilic enterocolitis (or gastroenteritis) is a manifestation of type I allergic reaction to food allergen, which can not always be determined. The most often ill people aged 30-45 years. The stomach and small intestine are affected, sometimes - the large intestine, most often blind. The main clinical symptoms are: nausea, vomiting, diarrhea, abdominal pain, it is possible to detect the admixture of blood in the feces.

In the biopsy specimens of the mucous membrane of the affected organs, there is a picture of inflammation, which may even be transmural, which brings the disease closer to Crohn's disease. In addition, pronounced eosinophilic infiltration is highly characteristic. Unlike Crohn's disease with eosinophilic colitis, ulceration and granulomas are not observed. A characteristic feature is eosinophilia.

Lymphocytic colitis

Lymphocytic colitis is an inflammatory disease of the large intestine, characterized by lymphoid infiltration of the mucous membrane.

The etiology of the disease is unknown, men and women are equally sick. Clinical manifestations are the same as with collagen colitis. A characteristic feature of the disease is pronounced mononuclear inflammatory infiltration of the propria of the mucous membrane, as well as diffuse infiltration of both the superficial epithelium and the epithelium of crypts with a large number of interepithelial lymphocytes and neutrophils. In the normal mucosa of the large intestine, there are less than 5 interepithelial lymphocytes per 100 cells of the surface epithelium. With lymphocytic colitis, the number of interepithelial lymphocytes is 15-20 per 100 cells of the superficial epithelium and more, with all other inflammatory processes not more than 10.

Chronic colitis in diverticular disease

Chronic colitis in diverticular disease is an inflammatory process in the sigmoid colon, affected by diverticular disease.

The disease occurs in the elderly. Patients complain of bloody stool, pain in the left ileal region in the projection of the sigmoid colon. When palpation of the abdomen is determined soreness in the sigmoid colon. With sigmoidoscopy, there is a discharge or focal granularity and friability of the mucous membrane of the sigmoid colon, most pronounced around the mouth of the diverticulum. Proximal and distal to the sigmoid colon, the mucosa of the large intestine has not been altered. Histological examination may show signs of Crohn's disease, which does not exclude the simultaneous coexistence of two diseases.

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