Collagenous Colitis in a Young Adult: A Case Report

Collagenous colitis is a subtype of microscopic colitis characterized by chronic watery diarrhea, normal-appearing colonic mucosa on endoscopy, and a thickened subepithelial collagen band on histological examination. Although it is often observed in middle-aged women, increasing recognition of this condition has expanded its epidemiological spectrum. We describe the case of a 21-year-old woman presenting with persistent watery diarrhea and weight loss. Extensive evaluation, including endoscopy with biopsies, confirmed collagenous colitis. This case highlights diagnostic and therapeutic considerations in young patients with chronic diarrhea. Although colonoscopy findings may be normal, further mucosal biopsies are essential for diagnosis. Budesonide remains the first-line treatment and achieves high remission rates. Collagenous colitis should be considered in the differential diagnosis of chronic watery diarrhea, even in young adults. Furthermore, early biopsy and appropriate therapy are crucial for symptom control and improved quality of life.