{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:22:44Z","timestamp":1780352564775,"version":"3.54.1"},"reference-count":19,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1992,1]]},"abstract":"<jats:p>We investigated the distribution of the collagen band in 33 patients with collagenous colitis to estimate the likelihood of the disease being diagnosed in biopsy specimens from the left side of the colon, such as those obtained using flexible sigmoidoscopy. To be included in this study patients had a subepithelial collagen band greater than or equal to 10 microns, an increase in chronic inflammatory cells in the same specimen, and diarrhoea for which there was no other apparent cause. In 17 patients undergoing full colonoscopy with a thickened collagen band, collagenous colitis was frequently patchy, even though overall the thickened collagen band was almost equally distributed throughout the colon. Rectal biopsy specimens showed a normal collagen band in 73% of patients, while a thickened collagen band was found in 82% of patients in at least one specimen from the left side of the colon. Three patients had a thickened collagen band only in the caecum. In three of eight rectal biopsy specimens with a normal collagen band there was no mucosal inflammation to raise the possibility of proximal disease, although all but one specimen with a normal collagen band from the sigmoid and descending colon were inflamed. Rectal biopsy alone is therefore a relatively poor method of making the diagnosis. Flexible sigmoidoscopy with multiple biopsy specimens from several sites is a reasonable initial investigation but not sufficient to exclude collagenous colitis when based on the presence of a thickened collagen band alone. Should left sided biopsy specimens show a normal collagen band but an inflamed mucosa, total colonoscopy with multiple specimens including the caecum may be required to establish the diagnosis.<\/jats:p>","DOI":"10.1136\/gut.33.1.65","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"65-70","source":"Crossref","is-referenced-by-count":139,"title":["Distribution of collagenous colitis: utility of flexible sigmoidoscopy."],"prefix":"10.1136","volume":"33","author":[{"given":"M","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Mazzoleni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R H","family":"Riddell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1992,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/0046-8177(89)90198-6","article-title":"Lymphocytic ('microscopic') colitis: a comparative histopathologic study with particular reference to collagenous colitis","volume":"20","author":"Lazenby, A.J.; Yardley, J.H.; Giardiello, F.M.; Jessurun, J.; Bayless, T.M.","year":"1989","unstructured":"Lazenby AJ, Yardley JH, Giardiello FM, Jessurun J, Bayless TM. Lymphocytic ('microscopic') colitis: a comparative histopathologic study with particular reference to collagenous colitis. Hum Pathol 1989; 20: 18-28.","journal-title":"Hum Pathol"},{"key":"ref_2","first-page":"763","article-title":"Collagenous colitis and microscopic colitis: the watery diarrhea-colitis syndrome","volume":"84","author":"Sylwestrowicz, T.; Kelly, J.K.; Hwang, W.S.; Shaffer, E.A.","year":"1989","unstructured":"Sylwestrowicz T, Kelly JK, Hwang WS, Shaffer EA. Collagenous colitis and microscopic colitis: the watery diarrhea-colitis syndrome. Am J Gastroenterol 1989; 84: 763-8.","journal-title":"Am J Gastroenterol"},{"key":"ref_3","first-page":"767","article-title":"Collagenous enterocolitis: a case of collagenous colitis with involvement of the small intestine","volume":"83","author":"Eckstein, R.P.; Dowsett, J.F.; Riley, J.W.","year":"1988","unstructured":"Eckstein RP, Dowsett JF, Riley JW. Collagenous enterocolitis: a case of collagenous colitis with involvement of the small intestine. AmJ Gastroenterol 1988; 83: 767-71.","journal-title":"AmJ Gastroenterol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/0016-5085(84)90546-8","article-title":"Development of collagenous colitis in sequential biopsy specimens","volume":"87","author":"Teglbjaerg, P.S.; Thaysen, E.H.; Jensen, H.H.","year":"1984","unstructured":"Teglbjaerg PS, Thaysen EH, Jensen HH. Development of collagenous colitis in sequential biopsy specimens. Gastroenterology 1984; 87: 703-9.","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/BF00783020","article-title":"Collagenous colitis: histologic, morphometric, immunohistochemical and ultrastructural studies. Report of 21 cases","volume":"413","author":"Widgren, S.; Jlidi, R.; Cox, J.N.","year":"1988","unstructured":"Widgren S, Jlidi R, Cox JN. 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