Letter: lansoprazole consumption is more common in Japanese patients with collagenous colitis
Abstract
We read with interest the article by Keszthelyi et al.1 Their retrospective, case–control study indicated exposure to proton pump inhibitors to be associated with an increase in the risk of microscopic colitis (MC). Fernández-Bañares et al.2 also reported that lansoprazole is an independent risk factor for collagenous colitis (CC), whereas its contribution to the development of CC is almost equivalent to that of other medications, such as nonsteroidal anti-inflammatory drugs and aspirin. Such a subtle influence on the risk of CC may be explained by a low consumption rate of lansoprazole (8.3%) in European patients with CC. CC has been increasingly reported in Japan during the past decade. It is especially the case for lansoprazole-associated CC, and the consumption rate of lansoprazole in Japanese patients ranges from 53% to 83%.3-5 At our institution, lansoprazole was administered in 39 of 45 (87%) patients at the time of diagnosis. Such an obvious difference in the rate of lansoprazole use between European and Japanese patients with CC seems to be a consequence of differences in environmental and genetic factors. We experienced an intriguing case of lansoprazole-associated CC. A 77-year-old Japanese female complained of intractable watery diarrhoea, and she had been continuously taking lansoprazole for her recurrent duodenal ulcers. Because histological findings on colonic biopsy were compatible with CC, lansoprazole was changed to rabeprazole, resulting in a resolution of…
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