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Collagenous Colitis

Living with collagenous colitis means coping with frequent, watery diarrhea and abdominal discomfort-but relief is possible. At GastroDoxs in Houston, Dr. Scott offers expert diagnosis, personalized diet changes, and targeted medications designed to reduce inflammation and restore your digestive health.

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Texas Medical Board
Harris County Medical Society
American College of Gastroenterology
American Society for Gastrointestinal Endoscopy
Memorial hermann
Houston Methodist leading Medicine
HCA Houston Healthcare
Scott Liu

About the Expert

Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.

Common Causes and Risk Factors

  • Age over 50
  • Use of NSAIDs or acid‐blocking medications
  • Underlying autoimmune disorders (e.g., thyroid disease, arthritis)
  • History of smoking
  • Family history of inflammatory bowel conditions

Signs and Symptoms

  • Frequent, watery diarrhea
  • Abdominal cramps and bloating
  • Sudden, urgent need to use the bathroom
  • Fatigue due to sleep disruption or dehydration
  • Mild weight loss with prolonged symptoms

How Dr. Scott Diagnoses Collagenous Colitis

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

Medical History and Physical Exam

He reviews your bowel habits, medication and supplement use, autoimmune history, and any family history of GI disorders.

Stool Studies

Stool tests are ordered to rule out infections, parasites, and other causes of chronic diarrhea.

Colonoscopy and Biopsy

  • During colonoscopy, he examines the mucosal lining for inflammation or ulceration.
  • A small tissue sample is taken to look for the characteristic thickened collagen band under the colon lining.

Additional Testing (if needed)

In select cases, blood tests (to exclude celiac disease or thyroid disorders) or imaging studies (to assess for other colitis types) may be added.

Dr. Scott
Treatment

Our Team offers a full range of care for collagenous colitis.

1. Lifestyle and Diet Modifications

  • Low-fat, low-fiber meals during flare-ups
  • Avoidance of alcohol, caffeine, and sugar substitutes
  • Keeping a food diary to identify personal triggers
  • Increased daily water intake to stay hydrated

2. Medications

  • Budesonide, a targeted steroid to reduce inflammation
  • Anti-diarrheal agents such as loperamide
  • Bile acid binders when bile acids contribute to symptoms
  • Probiotics to support healthy gut bacteria balance

3. Other Treatment Options

  • Non-surgical monitoring with specialized imaging or endoscopy
  • Rare consideration of surgery only if all other treatments fail
  • Ongoing follow-up care to adjust therapy as needed
Scott Liu

About the Expert

Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.

Frequently Asked Questions

How long does it take to get better?

Most patients feel better in 4 to 6 weeks with the right treatment.

Is collagenous colitis permanent?

It can last a long time, but many people go into remission with proper care and management.

Should I stop eating dairy?

Some people feel worse after eating dairy. Try avoiding it to see if you feel better and discuss your diet with Dr. Scott.

Will I need surgery?

No. Surgery is almost never needed. Most cases improve with medication and lifestyle changes.

What's the difference between collagenous and lymphocytic colitis?

Both cause chronic diarrhea. Collagenous colitis shows a thick collagen band on biopsy, while lymphocytic colitis shows increased immune cells.

Can stress make symptoms worse?

Yes. Stress may trigger or worsen flare-ups. Techniques like walking, yoga, and breathing exercises can help.

Do probiotics help?

They may help balance gut bacteria. Ask Dr. Scott about the best type and dose for your condition.

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