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Macroscopic findings in collagenous colitis : A multi-center, retrospective, observational cohort study

Koulaouzidis, Anastasios LU ; Yung, Diana E; Nemeth, Artur LU ; Sjöberg, Klas LU ; Giannakou, Andry; Qureshi, Raheel; Bartzis, Leonidas; McNeill, Morna; Johansson, Gabriele Wurm LU and Lucendo, Alfredo J., et al. (2017) In Annals of Gastroenterology 30(3). p.309-314
Abstract

Background Collagenous colitis (CC) is by definition a histological diagnosis. However, colonoscopy often reveals characteristic endoscopic findings. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in 4 participating centers. Methods This was a retrospective study; the databases of 2 university hospitals in Edinburgh (Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso (Spain) and Gateshead (England) were interrogated for patients diagnosed with CC between May 2008 and August 2013. Endoscopy reports and images were retrieved and reviewed; data on lesions, sedation, bowel preparation and endoscopist experience were abstracted. Categorical data are... (More)

Background Collagenous colitis (CC) is by definition a histological diagnosis. However, colonoscopy often reveals characteristic endoscopic findings. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in 4 participating centers. Methods This was a retrospective study; the databases of 2 university hospitals in Edinburgh (Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso (Spain) and Gateshead (England) were interrogated for patients diagnosed with CC between May 2008 and August 2013. Endoscopy reports and images were retrieved and reviewed; data on lesions, sedation, bowel preparation and endoscopist experience were abstracted. Categorical data are reported as mean±SD. Fischer’s exact, chi-square and t (unpaired) tests were used to compare datasets. A two-tailed P-value of <0.05 was considered statistically significant. Results 607 patients (149 male, mean age 66.9±12.25 years) were diagnosed with CC. A total of 108/607 (17.8%) patients had one or more suggestive endoscopy findings: i.e., mucosal erythema/edema, 91/607 (15%); linear colonic mucosal defects, 12/607 (2%); or mucosal scarring, 5/607 (0.82%). For colonic mucosa erythema, there was no difference in the odds of finding erythema with the use of different bowel preparation methods (P=0.997). For colonic mucosal defects there was some evidence (P=0.005) that patients colonoscoped by experienced endoscopists had 87% less odds of developing such defects. Moreover, there was evidence that analgesia reduced the odds of developing mucosal defects by 84%. Conclusion A significant minority of patients with CC have endoscopic findings in colonoscopy. The description of such findings appears to be related to the endoscopist’s experience.

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published
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keywords
Colonoscopy, Endoscopist training, Macroscopic findings, Microscopic colitis, Observational study
in
Annals of Gastroenterology
volume
30
issue
3
pages
6 pages
publisher
Hellenic Society of Gastroenterology
external identifiers
  • scopus:85018334665
  • wos:000413649200007
ISSN
1108-7471
DOI
10.20524/aog.2017.0131
language
English
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yes
id
d699b5d1-ea04-40fa-9c1e-a04a2d40239a
date added to LUP
2017-05-19 10:07:13
date last changed
2018-01-16 13:26:35
@article{d699b5d1-ea04-40fa-9c1e-a04a2d40239a,
  abstract     = {<p>Background Collagenous colitis (CC) is by definition a histological diagnosis. However, colonoscopy often reveals characteristic endoscopic findings. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in 4 participating centers. Methods This was a retrospective study; the databases of 2 university hospitals in Edinburgh (Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso (Spain) and Gateshead (England) were interrogated for patients diagnosed with CC between May 2008 and August 2013. Endoscopy reports and images were retrieved and reviewed; data on lesions, sedation, bowel preparation and endoscopist experience were abstracted. Categorical data are reported as mean±SD. Fischer’s exact, chi-square and t (unpaired) tests were used to compare datasets. A two-tailed P-value of &lt;0.05 was considered statistically significant. Results 607 patients (149 male, mean age 66.9±12.25 years) were diagnosed with CC. A total of 108/607 (17.8%) patients had one or more suggestive endoscopy findings: i.e., mucosal erythema/edema, 91/607 (15%); linear colonic mucosal defects, 12/607 (2%); or mucosal scarring, 5/607 (0.82%). For colonic mucosa erythema, there was no difference in the odds of finding erythema with the use of different bowel preparation methods (P=0.997). For colonic mucosal defects there was some evidence (P=0.005) that patients colonoscoped by experienced endoscopists had 87% less odds of developing such defects. Moreover, there was evidence that analgesia reduced the odds of developing mucosal defects by 84%. Conclusion A significant minority of patients with CC have endoscopic findings in colonoscopy. The description of such findings appears to be related to the endoscopist’s experience.</p>},
  author       = {Koulaouzidis, Anastasios and Yung, Diana E and Nemeth, Artur and Sjöberg, Klas and Giannakou, Andry and Qureshi, Raheel and Bartzis, Leonidas and McNeill, Morna and Johansson, Gabriele Wurm and Lucendo, Alfredo J. and Fineron, Paul and Trimble, Ken C. and Saeed, Athar and Plevris, John N and Toth, Ervin},
  issn         = {1108-7471},
  keyword      = {Colonoscopy,Endoscopist training,Macroscopic findings,Microscopic colitis,Observational study},
  language     = {eng},
  number       = {3},
  pages        = {309--314},
  publisher    = {Hellenic Society of Gastroenterology},
  series       = {Annals of Gastroenterology},
  title        = {Macroscopic findings in collagenous colitis : A multi-center, retrospective, observational cohort study},
  url          = {http://dx.doi.org/10.20524/aog.2017.0131},
  volume       = {30},
  year         = {2017},
}