Microscopic Colitis

Definition

• 
  Colon and rectum

Microscopic colitis is an inflammation of the large intestine (colon) that causes persistent watery diarrhea. The disorder gets its name from the fact that it's necessary to examine colon tissue under a microscope to identify it.

There are two types of microscopic colitis:

• Collagenous colitis, in which a thick layer of protein (collagen) develops in colon tissue
• Lymphocytic colitis, in which white blood cells (lymphocytes) increase in colon tissue

It isn't known whether collagenous (kuh-LAYJ-uh-nus) colitis and lymphocytic colitis are two separate disorders or represent different phases of the same condition. However, symptoms of collagenous colitis and lymphocytic colitis are similar, as are testing and treatment.

The symptoms of microscopic colitis can come and go frequently. Sometimes the symptoms resolve on their own. If not, your doctor can suggest a number of effective medications.

Symptoms 

Signs and symptoms of microscopic colitis include:

• Chronic watery diarrhea
• Abdominal pain or cramps
• Weight loss
• Nausea
• Fecal incontinence

When to see a doctor

If you have watery diarrhea that lasts more than a few days, contact your doctor so that your condition can be diagnosed and properly treated.

Causes

It's not clear what causes the inflammation of the colon found in microscopic colitis. Researchers believe that the causes may include:

• Medications that can irritate the lining of the colon
• Bacteria that produce toxins that irritate the lining of the colon
• Viruses that trigger inflammation
• Immune system problems, such as rheumatoid arthritis or celiac disease, that occur when your body's immune system attacks healthy tissues.

Risk factors

Risk factors for microscopic colitis include:

• Age and gender. Microscopic colitis is most common in people ages 50 to 70 and more common in women than men.
• Immune system problems. People with microscopic colitis sometimes also have an autoimmune disorder, such as celiac disease, thyroid disease or rheumatoid arthritis.
• Smoking. Recent research studies have shown an association between tobacco smoking and microscopic colitis, especially in people ages 16 to 44.

Some research studies indicate that using certain medications may increase your risk of microscopic colitis. But not all studies agree. Medications linked to the condition include:

• Aspirin, acetaminophen (Tylenol, others), and ibuprofen (Advil, Motrin IB, others)
• Proton pump inhibitors, including lansoprazole
• Acarbose (Precose)
• Flutamide
• Ranitidine (Zantac)
• Selective serotonin reuptake inhibitors, such as sertraline (Zoloft)
• Carbamazepine

It's not clear why some people who use these medications develop microscopic colitis while others don't.

Test and diagnosis

A complete medical history and physical examination can help determine whether other conditions may be contributing to your diarrhea, including:
• Celiac disease
• Autoimmune disorders, such as rheumatoid arthritis
Your doctor will ask about any medications you are taking, particularly aspirin and ibuprofen, which may increase your risk of microscopic colitis.
Tests used to diagnose microscopic colitis may include:
• Stool sample analysis to help rule out infection as the cause of persistent diarrhea.
• Blood test or upper endoscopy with biopsy to rule out celiac disease. In endoscopy, a long, thin tube with a camera on the end is used to examine the upper part of your digestive tract. A tissue sample (biopsy) may be removed for analysis in the laboratory.
• Colonoscopy or flexible sigmoidoscopy with biopsy to help rule out other intestinal disorders. Both tests use a long, thin tube with a camera on the end to examine the inside of your colon. The colons of people with microscopic colitis appear normal. A biopsy can be obtained during colonoscopy or flexible sigmoidoscopy and analyzed for signs of microscopic colitis.

Lifestyle and home remedies

Changes to your diet may help relieve diarrhea that you experience with microscopic colitis. Try to:
• Drink plenty of fluids. Water is best, but fluids with added sodium and potassium (electrolytes) may help as well. Try drinking broth or watered-down fruit juice. Avoid beverages that are high in sugar or contain alcohol or caffeine, such as coffee, tea and colas, which may aggravate your symptoms.
• Choose soft, easy-to-digest foods. These include applesauce, bananas and rice. Avoid high-fiber foods such as beans, nuts and vegetables. If you feel as though your symptoms are improving, slowly add high-fiber foods back to your diet.
• Eat several small meals rather than a few large meals.Spacing meals throughout the day may ease diarrhea.
• Avoid irritating foods. Stay away from spicy, fatty or fried foods and any other foods that make your symptoms worse.
  
  
        
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
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