A review of the literature also revealed patients with microscopic colitis
can also be asymptomatic or present with Irritable bowel syndrome (IBS)-like symptoms with diarrhoea alternating with constipation.
Bohr et al., "Microscopic colitis
: current status, present and future challenges: statements of the European Microscopic Colitis
Group," Journal of Crohn's and Colitis, vol.
"If a patient has diarrhea-predominant IBS and undergoes colonoscopy, it is reasonable to consider taking random biopsies to exclude microscopic colitis
," said Dr.
The 3 main causes of treatment failure are (i) inadvertent or intentional failure to adhere to a strict gluten-free diet; (ii) other complicating or coexisting conditions such as small-bowel bacterial overgrowth, lactose intolerance, or microscopic colitis
; and (iii) disease refractoriness to a gluten-free diet.
Other etiologies included malabsorption (35% and 28%), microscopic colitis
(15% and 9%), inflammatory bowel disease (16% and 10%), and celiac sprue (0% and 3%).
Nonsteroidal anti-inflammatory drugs can also induce different patterns of colitis, including microscopic colitis
(lymphocytic or collagenous), focal active colitis, IBD-like colitis, or ischemic colitis (2) (discussed in subsequent sections).
"If a patient has diarrhea-predominant IBS and undergoes colonoscopy, then it is reasonable to consider taking random biopsies to exclude microscopic colitis
," said Dr.
Expert consensus says that all chronic diarrhea patients with normal endoscopic findings should have the colon biopsied to look for microscopic colitis
. Sigmoidoscopy may be most appropriate for young patients with chronic watery diarrhea without blood or pus in the stool who do not have irritable bowel syndrome by clinical criteria, suggested Lawrence R.
In addition, the predominant pattern of injury is lymphocytic or collagenous colitis with no significant endoscopic disease in microscopic colitis
. (24) Of note, IBD patients may display features of microscopic colitis
at the onset of the disease or during the follow-up (Figure 2, C).
-- Mesalamine produced clinical and histologic remission of microscopic colitis
and obviated the need for maintenance therapy in most patients, Dr.
Researchers and clinicians are increasingly implicating microscopic colitis
, which includes lymphocytic colitis and collagenous colitis, as a cause of chronic diarrhea, Dr.
The near-normal spectrum of changes evokes microscopic colitis
(MC) and other related entities.