Lansoprazole-Associated Collagenous Colitis: A Case Report

Abstract

A 57-year-old man developed chronic, watery diarrhea four weeks after Helicobacter pylori eradication therapy including lansoprazole followed by lansoprazole monotherapy for gastroesophageal reflux disease. Four weeks later the patient was admitted to our hospital. By repeated testing other causes of diarrhea, e. g., infectious diarrhea including Clostridium difficile colitis were excluded. Endoscopy showed a normal colon, histopathology of random biopsies of all sections of the colon demonstrated the characteristic features of collagenous colitis. Withdrawal of lansoprazole lead to prompt and sustained relief. Two months later repeat colonoscopy with biopsies showed no evidence of collagenous colitis. Collagenous colitis as a subtype of microscopic colitis is a rare cause of chronic diarrhea with unknown pathogenesis. The reported case represents an unusual association between medication with the proton pump inhibitor lansoprazole and the development of collagenous colitis suggesting the importance of evaluation of drug use in patients with microscopic colitis.

Lansoprazole-associated collagenous colitis: Diffuse mucosal cloudiness mimicking ulcerative colitis

“…Recently, lansoprazole has been shown to cause microscopic colitis [9][10][11][12]18] . The frequency of lansoprazoleassociated microscopic colitis is not known, but at least six of 850 subjects who took lansoprazole (0.7%) were found to develop microscopic colitis [10] .…”

“…The frequency of lansoprazoleassociated microscopic colitis is not known, but at least six of 850 subjects who took lansoprazole (0.7%) were found to develop microscopic colitis [10] . The period from www.wjgnet.com initiation of lansoprazole to the onset of diarrhea varies extensively from 5 d to 9 mo [9][10][11][12] . In our case, it was about 3 and 6 mo in the two episodes, respectively.…”

“…Treatment of lansoprazole-associated microscopic colitis is withdrawal of lansoprazole. Prompt resolution of diarrhea occurs within 1-10 d [9][10][11][12] . In our case, it was 1 d in the first episode and a few days in the second episode.…”

“…Following admission, we found that the patient had been taking lansoprazole since July 2, 2007 which was prescribed by another hospital. At this time, we were aware of lansoprazole-associated collagenous colitis [9][10][11][12] . Lansoprazole was withdrawn on December 16.…”

A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone

“…Since the first report in 1976 [1] , collagenous colitis has been found to be associated with a variety of conditions, including use of non-steroidal anti-inflammatory drugs [2] and proton pump inhibitors [3] . This condition is characterized by chronic watery diarrhea and abnormal deposition of collagen beneath the colonic epithelium [4] .…”