Microscopic Colitis

Microscopic colitis is a type of inflammatory bowel disease (IBD) that affects the large intestine (colon). It is characterized by inflammation and changes in the lining of the colon, which can only be seen under a microscope.

Types of Microscopic Colitis

There are two main types of microscopic colitis:

• Collagenous colitis: This type is characterized by a thickening of the collagen layer in the lining of the colon, which can lead to chronic diarrhea and abdominal pain.
• Lymphocytic colitis: This type is characterized by an increase in lymphocytes (a type of white blood cell) in the lining of the colon, which can also cause chronic diarrhea and abdominal pain.

Symptoms

The symptoms of microscopic colitis may include:

• Chronic diarrhea (watery or bloody)
• Abdominal pain or cramping
• Bloating and gas
• Weight loss
• Fatigue

Causes and Risk Factors

The exact cause of microscopic colitis is not known, but several factors may contribute to its development:

• Genetic predisposition
• Autoimmune disorders (e.g., celiac disease, rheumatoid arthritis)
• Infections (e.g., bacterial, viral)
• Medications (e.g., nonsteroidal anti-inflammatory drugs, antibiotics)
• Environmental factors (e.g., smoking, stress)

Diagnosis

Microscopic colitis is typically diagnosed through a combination of:

• Colonoscopy with biopsy: A procedure that allows a doctor to visually examine the colon and take tissue samples for examination under a microscope.
• Endoscopy: A procedure that uses a flexible tube with a camera to visualize the upper part of the gastrointestinal tract.
• Stool tests: To rule out other causes of diarrhea, such as infections or inflammatory bowel disease.

Treatment

Treatment for microscopic colitis usually involves:

• Anti-diarrheal medications (e.g., loperamide, bismuth subsalicylate)
• Anti-inflammatory medications (e.g., budesonide, mesalamine)
• Immunosuppressive medications (e.g., azathioprine, mercaptopurine) in severe cases
• Lifestyle modifications (e.g., dietary changes, stress management)

Prognosis and Complications

Microscopic colitis is a chronic condition that can be managed with treatment. However, if left untreated or poorly managed, it may lead to complications such as:

• Malnutrition and weight loss
• Anemia (due to chronic blood loss)
• Osteoporosis (due to malabsorption of calcium and vitamin D)