Is sulfasalazine the only known treatment for collagenous colitis?
The disorder you asked about, collagenous colitis, is a rare but treatable
inflammatory disorder of the colon. It is characterized by chronic watery
diarrhea (sometimes up to 30 times per day), which might lead to dehydration
weakness, malnutrition from not being able to eat properly, bloating, and
occasional nausea. About half of patients report that these symptoms
occur suddenly, with little warning. During an episode, certain foods —
especially those high in fiber and high in fat, dairy products, various spices,
and uncooked fruits and vegetables — might be triggers. Although, research has
shown little evidence of a link between food and collagenous colitis. Those at
highest risk for developing collagenous colitis are females over the age of 40,
but cases have been reported in children as young as seven.
Diagnosis is often reached through a process of elimination. Most cases are diagnosed
because there is little damage in the intestine shown during an endoscopic
examination (which eliminates other disorders, such as crohn's disease or
celiac sprue) and the diagnosis of a band of collagen in the biopsied cells of
the colon.
Several medicines have been found to be effective in treating collagenous
colitis. Successful clinical trials have included the use of medicines such as aminosalicylate,
prednisolone, metronidazole, cholestyramine, and bismuth subsalicylate.
It is also suggested that patients avoid using any non-steroidal
anti-inflammatory medicines (NSAIDs such as ibuprofen), because of a possible
link between patients taking NSAIDs for their arthritis-like symptoms and onset
of collagenous colitis.
The symptoms associated with collagenous colitis can be treated with anti-diarrheal
drugs such as loperamide. If loperamide does not control the symptoms,
sulfasalazine is sometimes added. Prednisone might also be prescribed for serious
chronic cases. About 25 percent of patients will require long-term therapy because
symptoms will resurface if treatment is stopped. Surgery is a radical approach
and is seldom used, except in extremely severe cases. As with any condition, you
should discuss your treatment options with you doctor.