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Background: Colitis is generally considered a risk factor for colon neoplasia. However, not all types of colitis seem to have equal neoplastic transformation potential., Aim: To determine the prevalence of colorectal polyps in a predominantly African American population with inflammatory bowel disease (IBD) and Non-IBD/Non-Infectious Colitis (NIC)., Methods: We retrospectively evaluated medical records of 1060 patients previously identified with colitis at Howard University Hospital, based on ICD-10 code. Among these, 485 patients were included in the study: 70 IBD and 415 NIC based on a thorough review of colonoscopy, pathology and clinical reports. Logistic regression analysis was applied to estimate the risk of polyps in patients with IBD compared to those with NIC after adjusting for age and sex. A subgroup analysis within the IBD group was performed., Results: Of the 485 patients, 415 were NIC and 70 were IBD. Seventy-three percent of the NIC patients and 81% of the IBD patients were African Americans. Forty six percent of IBD and 41% of NIC cases were male. IBD patients were younger than NIC patients (median age of 38 years vs. 50, P < 0.001). The prevalence of all types of polyps was 15.7 and 8.2% in the IBD and NIC groups, respectively (P = 0.045). Among patients with polyps, the prevalence of inflammatory polyps was higher in the IBD group (55%) compared to the NIC group (12%). After adjusting for age, sex and race, odds ratio of inflammatory polyps in IBD patients was 6.0 (P = 0.016). Adenoma prevalence was 4.3% (3/70) in IBD patients and 3.9% (16/415) in the NIC patients (p = 0.75). The anatomic distribution of lesions and colitis shows that polyps occur predominantly in the colitis field regardless of colitis type. More polyps were present in the ulcerative colitis patients when compared to Crohn's disease patients (27% vs. 5%, P < 0.001) within the IBD group., Conclusion: Our study shows that inflammatory polyps are more common in IBD patients when compared to NIC patients. Most polyps were in the same location as the colitis.

A case of collagenous colitis is reported. A 48 year old female who had been complaining of mild diarrhea had been under medication for a gastric ulcer. Colonoscopy revealed almost normal appearance of the colonic mucosa except for one hyperplastic polyp of the cecum. Specimens of the ascending, transverse and descending colon showed a distinctively thickened collagen band beneath the surface epithelium, 10-20 microns thick, which was irregularly distributed, even within the same specimen. In some areas, the thickened collagen band was found around the upper part of the pits. Periodic acid-Schiff (PAS), Azan staining and silver impregnation were positive for this thickened collagen band. Immunohistochemically, the thickened collagen band was weakly positive for collagen type III, but negative for collagen types I and IV. Plasma cells, lymphocytes and eosinophils were observed in the lamina propria in addition to intraepithelial lymphocytic infiltration. Capillaries were increased in the thickened collagen band. The arrangement of surface epithelial cells was irregular. Crypts were not distorted. Edema, diffuse or extensive fibrosis and congestion were not found. Through these findings the patient was diagnosed as having collagenous colitis. Many cases of this had been reported in western countries, but very few in Japan. The Japanese literature was reviewed for cases of collagenous colitis and it was found that only two cases had been presented.

Schistosomiasis is rare in Israel but very common in Africa. The recent Ethiopian immigration has brought us cases of parasitic diseases unfamiliar to Israeli physicians. 3 cases with uncommon manifestations of colonic schistosomiasis are described. The first had bloody diarrhea for 4 years. The second had co-infection with Salmonella D. The third was diagnosed as having schistosomal colitis on routine sigmoidoscopy, which was performed following diagnosis of rectal carcinoma in her brother.