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Review
. 2008 Dec 28;14(48):7280-8.
doi: 10.3748/wjg.14.7280.

Diagnosis and management of microscopic colitis

Curt Tysk  1 , Johan Bohr, Nils Nyhlin, Anna Wickbom, Sune Eriksson
Affiliations
Review

Diagnosis and management of microscopic colitis

Curt Tysk et al. World J Gastroenterol. .

Abstract

Microscopic colitis, comprising collagenous and lymphocytic colitis, is characterized clinically by chronic watery diarrhea, and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100,000 inhabitants, with a peak incidence in 60-70-year-old individuals and a noticeable female predominance for collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue and fecal incontinence are common symptoms, which impair the health-related quality of life of the patient. There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented short-term treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.

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Figures

Figure 1
Figure 1
Age- and sex-specific incidence of CC (A) and LC (B). Reprinted with permission from Gut 2004; 53: 346-350[5].
Figure 2
Figure 2
Biopsy from colon. A: normal colonic mucosa (H&E stain); B: typical findings of CC-increased subepithelial collagen layer, inflammation of lamina propria and epithelial cell damage with intraepithelial lymphocytes (Van Gieson's stain); C: typical findings of LC-epithelial cell damage with intraepithelial lymphocytes and inflammation in the lamina propria (H&E stain).
Figure 3
Figure 3
Tenascin immunostaining in CC.
Figure 4
Figure 4
Immunostaining of CD3+ T lymphocytes in LC.
Figure 5
Figure 5
Treatment algorithm for MC.
See this image and copyright information in PMC

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