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Diagnosis and management of microscopic colitis: Current perspectives
Örebro University, School of Health Sciences. Orebro University Hospital. Division of Gastroenterology, Department of Medicine.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Division of Gastroenterology, Department of Medicine, Örebro University Hospital.
Department of Laboratory Medicine/Pathology, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Division of Gastroenterology, Department of Medicine, Örebro University Hospital, Örebro, Sweden.
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2014 (English)In: Clinical and Experimental Gastroenterology, ISSN 1178-7023, E-ISSN 1178-7023, Vol. 7, 273-284 p.Article, review/survey (Refereed) Published
Abstract [en]

Collagenous colitis and lymphocytic colitis, together constituting microscopic colitis, are common causes of chronic diarrhea. They are characterized clinically by chronic nonbloody diarrhea and a macroscopically normal colonic mucosa where characteristic histopathological findings are seen. Previously considered rare, they now have emerged as common disorders that need to be considered in the investigation of the patient with chronic diarrhea. The annual incidence of each disorder is five to ten per 100,000 inhabitants, with a peak incidence in 60- to 70-year-old individuals and a predominance of female patients in collagenous colitis. The etiology and pathophysiology are not well understood, and the current view suggests an uncontrolled mucosal immune reaction to various luminal agents in predisposed individuals. Clinical symptoms comprise chronic diarrhea, abdominal pain, fatigue, weight loss, and fecal incontinence that may impair the patient's health-related quality of life. An association is reported with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. The best-documented treatment, both short-term and long-term, is budesonide, which induces clinical remission in up to 80% of patients after 8 weeks' treatment. However, after successful budesonide therapy is ended, recurrence of clinical symptoms is common, and the best possible long-term management deserves further study. The long-term prognosis is good, and the risk of complications, including colonic cancer, is low. We present an update of the epidemiology, pathogenesis, diagnosis, and management of microscopic colitis.

Place, publisher, year, edition, pages
Macclesfield, United Kingdom: Dove Medical Press Ltd.(Dovepress) , 2014. Vol. 7, 273-284 p.
Keyword [en]
Budesonide, chronic diarrhea, collagenous colitis, lymphocytic colitis, microscopic colitis
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-55056DOI: 10.2147/CEG.S63905PubMedID: 25170275Scopus ID: 2-s2.0-84925515491OAI: oai:DiVA.org:oru-55056DiVA: diva2:1069732
Available from: 2017-01-30 Created: 2017-01-30 Last updated: 2017-03-14Bibliographically approved

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Bohr, JohanWickbom, AnnaNyhlin, NilsHultgren-Hörnquist, ElisabethTysk, Curt
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School of Health SciencesOrebro University HospitalSchool of Health and Medical Sciences, Örebro University, Sweden
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Clinical and Experimental Gastroenterology
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