Vol. 27, suppl. 1, 2009 article (references) article (pdf 324 kb) ibd and ibs: novel mechanisms and future practice. Editor(s): travis s. P. L. (oxford), spiller r. C. (nottingham), colombel j. -f. (lille), holzer p. (graz) paper collagenous and lymphocytic colitis: systematic review and update of the literature f. Temmerman, f. Baert department of internal medicine, section of gastroenterology, h. Hart ziekenhuis roeselare, menen, belgium address of corresponding author dig dis 2009;27 (suppl. 1):137-145 (doi: 10. 1159/000268134) key words microscopic colitis collagenous colitis lymphocytic colitis budesonide abstract collagenous and lymphocytic colitis are well-described conditions causing chronic watery diarrhoea. A peak incidence from 60 to 70 years of age with a female predominance mainly in collagenous colitis is observed. Both conditions are characterised by a (near) normal colonoscopy, but with specific histologic findings on colonic biopsies. Histopathologically, both conditions are characterised by distinct epithelial abnormalities and a dense lymphoplasmocytic infiltrate. Distinct features consist of a characteristic collagen band deposition in the subepithelial layer in collagenous colitis and a markedly increased number of intra-epithelial lymphocytes in lymphocytic colitis. Although most cases are idiopathic, certain drugs can induce microscopic colitis. In addition, either condition can be associated with coeliac disease. For a long time patients with microscopic colitis were treated with non-specific anti-diarrhoeal agents, anti-inflammatory agents such as mesalazine, or systemic steroids, but with disappointing results. Bismuth subsalicylate was reported to be effective in a small controlled series of patients with collagenous colitis. Now, randomised controlled trials have shown the effectiveness of budesonide over placebo in collagenous colitis and more recently in lymphocytic colitis. The histologic response is variable, but a decrease in the subepithelial collagen layer and a decrease in the lymphoplasmocytic infiltrate in the lamina propria is observed in about half of the patients. In general, patients respond within 2 weeks with no major side effects. However, relapse is common (63–80% of patients) when budesonide is stopped. Longer-term treatment is effective but does not seem to reduce relapse rates upon discontinuation. Copyright © 2010 s. Karger ag, basel author contacts filip baerth. Hartziekenhuiswilgenstraat 2be–8800 roeselare (belgium)e-mail fbaert@hhr. cheapest prices on generic viagra generic viagra online buy generic viagra no prescription cheap viagra cialis vs viagra genericviagraforsalenoprescription.accountant Be article information number of print pages : 9 number of figures : 3, number of tables : 3, number of.