Clinical presentation, diagnosis, pathogenesis and treatment options for lymphocytic colitis (Review)

El-Salhy,Magdy; Gundersen,Doris; Hatlebakk,Jan  Gunnar; Hausken,Trygve

doi:10.3892/ijmm.2013.1385

August 2013 Volume 32 Issue 2

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August 2013 Volume 32 Issue 2

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Review

Clinical presentation, diagnosis, pathogenesis and treatment options for lymphocytic colitis (Review)

Authors:
- Magdy El-Salhy
- Doris Gundersen
- Jan Gunnar Hatlebakk
- Trygve Hausken
View Affiliations / Copyright

Affiliations: Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, Stord, Norway, Department of Research, Helse-Fonna, Haugesund, Norway, Section for Gastroenterology, Institute of Medicine, University of Bergen, Bergen, Norway
Pages: 263-270
|
Published online on: May 21, 2013

https://doi.org/10.3892/ijmm.2013.1385
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Abstract

Lymphocytic colitis (LC) is characterized by chronic or relapsing non-bloody watery diarrhea and a macroscopically normal colon. However, histopathological examination of colonic biopsy samples reveals an increased intraepithelial infiltration of lymphocytes (≥20/100 enterocytes), and increased inflammatory cells within the lamina propria, but with a normal mucosal architecture. The reported prevalence of LC varies from 14.2 to 45 per 100,000 individuals, while its reported incidence is between 0.6 and 16 per 100,000 individuals. LC has a high rate of spontaneous symptomatic remission and is not associated with an increased risk of colon cancer or inflammatory bowel disease. The diagnosis is based on the histopathological findings. The density of colonic chromogranin A-positive cells provides an effective diagnostic tool with high sensitivity and specificity in both the right and left colon. Gastrointestinal infections, drugs, and/or autoimmunity may trigger chronic colonic low-grade inflammation. Colonic nitric oxide, serotonin and peptide YY (PYY) cell densities are markedly increased in patients with LC. It has been hypothesized that the low-grade inflammation in LC through the endocrine-immune axis causes this increase. It has been postulated further that these abnormalities in the neuroendocrine system of the colon are responsible for the diarrhea observed in patients with LC. The benign course and rate of spontaneous remission of LC denotes that drugs with severe side-effects should be avoided if possible. The drug cost and drug coverage may also be limiting factors for some patients. These aspects should be taken into account when making decisions regarding treatment options.

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Clinical presentation, diagnosis, pathogenesis and treatment options for lymphocytic colitis (Review)

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