Microscopic colitis is an inflammatory disease of large intestine (colon) characterized by chronic watery diarrhea. The inflammations in the colon can only be detected through microscopic evaluation, hence the name microscopic colitis.
Microscopic colitis is of two types:
Collagenous colitis is a condition characterized by build-up of a thick layer of collagen (a type of protein) in the colon tissue while lymphocytic colitis is characterized by an increased number of white blood cells (lymphocytes) in the colon tissue.
It’s not clear if these two kinds are separate conditions or different stages of the same condition. The symptoms, diagnosis and treatment of both kinds are similar.
The symptoms may be often “on” or “off”. Medications are prescribed if the symptoms don't subside on their own.
The common signs and symptoms of microscopic colitis are:
Try following measures to get relief from diarrhea:
Eat plain, low-fat foods.
Avoid dairy products, spicy foods, caffeine and alcohol.
Physical examination along with your medical history can help to identify the cause of diarrhea. Other medical conditions, such as celiac disease or rheumatic arthritis (an autoimmune disease), may also cause diarrhea. Aspirin and ibuprofen are associated with increased risk of microscopic colitis.
Following test may be used to diagnose microscopic colitis:
Stool sample analysis to determine whether diarrhea is caused by infection.
Blood test or upper endoscopy with biopsy may be done to ensure that diarrhea is not caused by celiac disease. Endoscopy is a non-surgical procedure in which a long, thin tube with a camera on the end is guided into the upper part of your digestive tract to examine it. A tissue sample (biopsy) may be removed for analysis in the laboratory.
Colonoscopy or flexible sigmoidoscopy with biopsy is done rule out other intestinal disorders. Both tests use a long, thin tube with a camera on the end to examine the interior of your colon. The colons of people with microscopic colitis may also appear normal. A biopsy can be obtained during colonoscopy or flexible sigmoidoscopy and viewed under microscope to identify microscopic colitis.
Microscopic colitis requires treatment when symptoms are persistent or severe. Treatment options include:
Diet and medication changes: Changes in diet and medication can relieve chronic diarrhea. You may be recommended to:
Medications: Medications are recommended if signs and symptoms are persistent. Your doctor may suggest following medications:
Medications that bind to bile acids
Steroid or anti-inflammatory medications to reduce swellings in your colon
Immune suppressing drugs that suppress the immune system and eventually reduce inflammation in the colon
Surgery: Surgery is reserved for severe microscopic colitis, and those unresponsive to medications. Either a part of colon or entire colon is removed. Surgery, a rare treatment for microscopic colitis, is performed only when other causes of diarrhea have been ruled out.
6 Lifestyle and Coping
To relieve diarrhea associated with microscopic colitis, following lifestyle modifications can be helpful:
Drink plenty of fluid specially water. Fluid with electrolytes (sodium and potassium) can also help.
Avoid drinks which worsen your symptoms. Avoid drinks that are high in sugar, contain caffeine or alcohol.
Eat bland food. Plain foods are easy to digest.
Avoid foods that has high amount of fiber. Avoid spicy, fatty or fired foods which can aggravate your symptoms
Eating several small meals are more beneficial than a few large meals
7 Risks and Complications
There are several risks associated with microscopic colitis, which include:
Age and gender: Individuals, especially female, aged 50 to 70 are at an increased risk of developing microscopic colitis.
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