Lymphocytic colitis: clinical presentation and long term course

Background—Lymphocytic colitis is characterised bychronic watery diarrhoea with normal endoscopic or radiologicalfindings and microscopic evidence of pronounced infiltration of thecolonic mucosa with lymphocytes.
Aim—To investigate the long term clinical andhistological evolution of the disease in a large group of patients withwell characterised lymphocytic colitis.
Methods—Between 1986 and 1995 the histologicaldiagnosis of lymphocytic colitis was obtained in 35 patients; 27 ofthese agreed to a follow up examination. All clinical, endoscopic, andhistopathological records were reviewed at that time and the patientshad a second endoscopic examination with follow up biopsies.
Results—The patients initially presented with thetypical findings of lymphocytic colitis. After a mean (SD) follow up of 37.8 (27.5) months, diarrhoea subsided in 25 (93%) and histological normalisation was observed in 22 (82%) of the 27 patients. Progression from lymphocytic colitis to collagenous colitis was not observed.
Conclusions—Lymphocytic colitis is characterisedby a benign course with resolution of diarrhoea and normalisation ofhistology in over 80% of patients within 38 months. Considering thebenign course of the disease, the potential benefit of any drugtreatment should be carefully weighed against its potential side effects.

Keywords:lymphocytic colitis; colitis; diarrhoea