Microscopic colitis
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2008-05-28T07:55:16Z
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'''Microscopic colitis''' refers to two medical conditions which cause [[diarrhoea]]: [[collagenous colitis]] and [[lymphocytic colitis]]. Both conditions are characterised by the following triad of clinicopathological features:
# Chronic watery diarrhoea;
# Normal [[colonoscopy]];
# Characteristic [[histopathology]].
== Clinical features ==
Patients are characteristically, though not exclusively, middle-aged [[female]]s. They present with a long history of watery diarrhoea, which may be profuse. There is a higher incidence of [[autoimmune disease]]s, for example [[arthritis]], [[Sjögren's syndrome]], and [[coeliac disease]], in patients with microscopic colitis. There are reports of associations with multiple drugs, especially non-steroidal anti-inflammatory drugs ([[NSAID]]s).
Colonoscopy is normal or near normal. The changes are often patchy, so multiple colonic biopsies must be taken in order to make the diagnosis.{{Fact|date=February 2007}} A full colonoscopy is required, as an examination limited to the rectum will miss cases of microscopic colitis.
== Pathology ==
The hallmark of microscopic colitis is an increase in [[inflammatory cell]]s (i.e. [[lymphocytes]]) in colonic [[biopsies]] with an otherwise normal appearance and architecture of the colon. Inflammatory cells are increased both in the surface [[epithelium]] ("intraepithelial lymphocytes") and in the [[lamina propria]]. In lymphocytic colitis, these are the only abnormal features.
In collagenous colitis, the features of lymphocytic colitis are present, with in addition the presence of a thickened subepithelial [[collagen]] layer which may be up to 30 [[micrometre]]s thick.
== Treatment ==
No single treatment is accepted as the standard and measuring response is difficult. Often a trial of [[anti-diarrhoeal]]s is followed by [[anti-inflammatory drug]]s.
Lymphocytic colitis is thought to respond well to Pepto-Bismul, [[mesalazine]] and collagenous colitis to [[budesonide]].<ref name=fernandez>{{cite journal | author = Fernández-Bañares F, Salas A, Esteve M, Espinós J, Forné M, Viver J | title = Collagenous and lymphocytic colitis. evaluation of clinical and histological features, response to treatment, and long-term follow-up. | journal = Am J Gastroenterol | volume = 98 | issue = 2 | pages = 340–7 | year = 2003 | pmid = 12591052 | doi = 10.1111/j.1572-0241.2003.07225.x}}</ref>
==Prognosis==
The prognosis for lymphocytic colitis and collagenous colitis is good and both conditions are considered to be benign.<ref name=mullhaupt>{{cite journal | author = Mullhaupt B, Güller U, Anabitarte M, Güller R, Fried M | title = Lymphocytic colitis: clinical presentation and long term course. | journal = Gut | volume = 43 | issue = 5 | pages = 629–33 | year = 1998 | pmid = 9824342}}</ref> The majority of people afflicited with the conditions recover from their diarrhoea and their histological abnormalities resolve.<ref name=fernandez/>
==See also==
*[[Colitis]]
==References==
<references/>
==External links==
*[http://www.microscopiccolitis.org MicroscopicColitis.org]
[[Category:Gastroenterology]]
[[pl:Mikroskopowe zapalenie jelita grubego]]