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  • Review Article
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Non-IBD and noninfectious colitis

Nature Clinical Practice Gastroenterology & Hepatology volume 5, pages 28–39 (2008)Cite this article

Abstract

A wide range of etiologies and pathogenic mechanisms underlie colitis. This Review provides an overview of the pathophysiology, epidemiology, histopathology, and clinical characteristics of noninfectious and non-IBD forms of colitis: microscopic colitis, Behçet's syndrome, diversion colitis, diverticular colitis, eosinophilic colitis, ischemic colitis, and radiation colitis. These more recently characterized and rare forms of colitis occur as either primary conditions or complications of other diseases. Most of these diseases are uncommon; therefore, epidemiologic data and data from controlled trials are not readily available. Practical guidelines for the diagnosis and therapy of these more recently characterized and rarer forms of colitis are given where possible.

Key Points

  • Rare forms of colitis—which include colitis not caused by infectious agents, drugs, or chronic IBD—are often troublesome for both the patient and the physician, especially during the often protracted diagnostic process

  • The noninfectious, non-IBD forms of colitis include microscopic colitis, Behçet's colitis, diversion colitis, diverticular colitis, eosinophilic colitis, ischemic colitis, and radiation colitis

  • Only a few randomized controlled studies have been performed in the recently characterized and rare forms of colitis and, in 2007, most therapeutic principles are still empirical

  • Epidemiologic studies on most of these disease entities are warranted

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Figure 1: Microscopic colitis.
Figure 2: Diversion colitis in a section of rectal mucosa.
Figure 3: Images of ischemic colitis.
Figure 4: Colonic telangiectatic lesions seen endoscopically in radiation colitis.
Figure 5: Photomicrograph of acute radiation colitis showing infiltration of primarily lymphocytes and macrophages into the colonic mucosa.

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Acknowledgements

This paper was supported by grants from the Augustinus Foundation, Director Emil C Hertz and spouse Inger Hertz Foundation, Aase and Ejnar Danielsens Foundation, the Foundation of Graduate Engineer Frode V Nyegaard and spouse, and the Foundation of Kathrine and Vigo Skovgaard.

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Authors and Affiliations

  1. at the Department of Medical Gastroenterology C, OH Nielsen is Associate Professor in Internal Medicine and Consultant Gastroenterologist, and J Rask-Madsen is Full Professor in Medical Gastroenterology and Consultant Gastroenterologist, Herlev Hospital, University of Copenhagen, Denmark.,

    Ole Haagen Nielsen & Jørgen Rask-Madsen

  2. B Vainer is Consultant Histopathologist at the Department of Pathology, Rigshospitalet, University of Copenhagen, Denmark.,

    Ben Vainer

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  1. Ole Haagen Nielsen
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Correspondence to Ole Haagen Nielsen.

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Haagen Nielsen, O., Vainer, B. & Rask-Madsen, J. Non-IBD and noninfectious colitis. Nat Rev Gastroenterol Hepatol 5, 28–39 (2008). https://doi.org/10.1038/ncpgasthep1005

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