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A typical patient with collagenous colitis is a middle-aged or elderly female who presents with chronic watery diarrhea. Endoscopy and imaging studies show no significant abnormalities. Some endoscopic studies have reported linear mucosal tears (so called “catch-scratch colon”) and even pseudomembranes in occasional cases of collagenous colitis.

This image shows the classic histologic features, including thickened subepithelial collagen band, increased mononuclear cells in the lamina propria, and intact crypt architecture. Image courtesy of: Raul Gonzalez, MD; Used with permission.
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