Abstract
We describe a case of collagenous colitis on maintenance hemodialysis. An 83-year-old Japanese woman suddenly developed watery diarrhea five to six times per day. She had been receiving hemodialysis three times a week for 3 months. The cause of chronic renal failure was unknown. She had been taking lansoprazole for 3 months. By repeated testing for other causes of diarrhea, e.g., infectious diarrhea including Clostridium difficile colitis were excluded. Colonoscopic examination of the transverse colon showed normal findings, but histological examination demonstrated subepithelial collagen bands, which is a characteristic feature of collagenous colitis. Lansoprazole was changed to ranitidine hydrochloride, but diarrhea persisted. After ranitidine hydrochloride was discontinued, diarrhea abruptly disappeared. Hypoalbuminemia and peripheral edema slowly improved thereafter. There has not been any previous report of hemodialysis patients with collagenous colitis. Since collagenous colitis was first described in 1976 and only recently recognized as a common cause of diarrhea, many physicians may not yet be aware of this entity. Physicians should consider collagenous colitis as a possible cause in patients with chronic diarrhea.
