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Collagenous Colitis - by Dr. Rishi Chadha

Collagenous colitis is a microscopic invasive bowel disease, which leads to chronic watery diarrhea. At GastroDoxs in Houston, Dr. Rishi Chadha will make precise diagnosis and treatment: including biopsies, diet, drugs and advanced treatments to recover shortly your gut health and quality of life.

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Texas Medical Board
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Rishi Chadha

About the Expert

Dr. Rishi Chadha, MD is a board‑certified gastroenterologist who specializes in preventive gastroenterology, colorectal cancer screening, and minimally invasive endoscopic procedures. He completed his fellowship at Sunrise Health GME in Las Vegas and previously trained in internal medicine at St. Vincent’s Medical Center in Connecticut.

What Is Collagenous Colitis?

Collagenous colitis is a microscopic type of colitis, which is typified by watery and persistent diarrhea. On microscopic observation, a layer of collagen (a structural protein) is observed as getting thick immediately below the colon in the lining. Although the bowel movements are frequent and urgent, colonoscopy or endoscopy shows a normal lumen. The symptoms usually recover fast with appropriate treatment and diagnosis.

Common Causes and Risk Factors

  • Medications such as NSAIDs (non-steroidal anti-inflammatories), PPIs (proton pump inhibitors), and certain antidepressants
  • Other autoimmune conditions, for example celiac disease or rheumatoid arthritis
  • Female gender, especially women over age 50
  • Cigarette smoking, which may worsen symptoms

Signs and Symptoms

  • Frequent, watery diarrhea (often four or more times a day)
  • Sudden, urgent need to use the bathroom or occasional incontinence
  • Abdominal cramping or pain
  • Fatigue, dehydration, or unintended weight loss over time

How Dr. Rishi Diagnoses Collagenous Colitis?

Dr. Rishi uses a step-by-step approach:

Medical History and Exam

He also examines bowel, medication history (NSAIDs, PPIs, antidepressants), autoimmune history and performs physical examination to exclude the presence of abdominal tenderness or distension in your body.

Stool Studies

Stool samples are analyzed with a view of excluding infections (bacteria, parasites), Clostridioides difficile, and are used to determine the level of inflammatory indicators such as fecal calprotectin.

Colonoscopy and Biopsy

  • A colonoscope inspects the lining of the colon which often looks normal to the naked eye.
  • Several biopsies are being performed to ensure that the characteristic thickened collagen band is approved by our pathologist under the microscope.

Additional Tests (if needed)

Blood tests of Celiac disease or thyroid functioning are ordered occasionally, or imaging (CT or MRI) to rule out other gastrointestinal diseases.

Rishi Chadha
Treatment

Our Houston team offers a full range of care for collagenous colitis.

Lifestyle and Diet Interventions

  • Keep off alcohol, caffeine, spicy, greasy, or high-fat food; cut back dairy where necessary.
  • Small, frequent meals can be taken to relieve pressure on the gut.
  • Be hydrated by drinking a lot of water or electrolytes.

Medications

  • Budesonide to suppress the colonic inflammation.
  • Anti-diarrheal preparation like loperamide or diphenoxylate to retard bowel movements.
  • Bismuth subsalicylate to calm and cover the gastrointestinal tract.

Minimal Invasive or Advanced Surgery

  • To restore normal gut microbiota, fecal microbiota transplant (FMT).
  • Participation in clinical trials in new treatments of microscopic colitis.
Rishi Chadha

About the Author

Dr. Rishi Chadha, MD is a board‑certified gastroenterologist who specializes in preventive gastroenterology, colorectal cancer screening, and minimally invasive endoscopic procedures. He completed his fellowship at Sunrise Health GME in Las Vegas and previously trained in internal medicine at St. Vincent’s Medical Center in Connecticut.

Frequently Asked Questions

What leads to collagenous colitis?

Some medications (NSAIDs, PPIs, antidepressants), autoimmune diseases (such as celiac disease), age (above 50), gender (women), and smoking can identify a collagenous colitis.

Is it dangerous to have collagenous colitis?

It is not life-threatening, however, and may spoil the normal way of life when left untreated characterized by watery diarrhea and weakness.

What is the diagnosis of the collagenous colitis?

To examine the characteristic collagen layer under a microscope and identify it your doctor will examine your health history and will conduct stool tests, a colonoscopy with biopsy.

Does Collagenous colitis disappear on its own?

Others do not require any help, whereas the majority of patients have dietary restrictions and medications to manage symptoms and avoid relapse.

What is the ICD-10 of collagenous colitis?

K52.82 is the official code of insurance and medical record.

How long until I feel better?

A significant number of patients report an improvement within several weeks of treatment, although in some cases, extending the length of drug therapy or changing the diet can be necessary.

Is it possible to travel with collagenous colitis?

Yes. Preparation Plan ahead- Make sure you are hydrated and bring antidiarrheal medication and map out restroom stops on the way.

Is lymphocytic colitis and collagenous colitis equivalent?

They are both chronic and watery diarrheal but are different on the microscope, collagenous colitis contains a thick layer of collagen whereas lymphocytic colitis contains excess lymphocytes.

Will I ever need surgery?

Operation is very infrequent and is only used on dire cases where medical or dietary treatment has failed.

Where can I read more?

Patient education resources of American College of Gastroenterology or request Dr. Chadha to provide you with reliable sources upon the visit.

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