Overview
Microscopic colitis is a type of inflammatory bowel disease (IBD) that affects the large intestine. It is called microscopic because the inflammation is only visible under a microscope, unlike other types of colitis where inflammation is visible during colonoscopy. There are two subtypes of microscopic colitis; collagenous colitis and lymphocytic colitis. Collagenous colitis, where a layer of protein called collagen grows in colon tissue and lymphocytic colitis, where white blood cells called lymphocytes grow in colon tissue. Symptoms can include weight loss, nausea, watery diarrhea (the most common symptom), abdominal pain and bloating and fecal incontinence. Several risk factors exist including smoking, women over age 50 and a history of autoimmune disease like celiac or thyroid disease.
How is it diagnosed?
A colonoscopy, upper endoscopy or flexible sigmoidoscopy can be performed to rule out any infection or IBD. During the colonoscopy, the doctor might see normal looking tissue so biopsy samples can confirm if it is microscopic colitis and which subtype; lymphocytic colitis or collagenous colitis. Your physician may also order stool tests to rule bacterial or parasitic infections. Blood tests can be ordered to rule out other conditions such as celiac disease or autoimmune disorders.
How is it treated?
Many treatment options exist including medications, dietary and lifestyle modifications. Microscopic colitis can get better on its own but if your symptoms don’t go away or are severe, you might need treatment to feel better. Some medications can include steroids, anti-diarrheal, immunosuppressants and biologics. Often, changes in diet and lifestyle can help relieve symptoms.
- Limit dairy, gluten, caffeine and sugar or following a low-fat, low fiber diet.
- Avoid any food that may trigger your symptoms like spicy or fried foods
- Managing stress, staying hydrated, and getting regular exercise may help improve symptoms.
- Regular follow-up with a gastroenterologist is important to monitor symptoms, adjust medications as needed, and assess for any complications or changes in disease activity.
Resources
The Crohn’s and Colitis Foundation website is a great resource on treatment options, IBD medications guide, information on diet and nutrition, research information, financial and insurance material and community support options.
https://www.crohnscolitisfoundation.org
References
Mayo Clinic. 2024. Microscopic Colitis. https://www.mayoclinic.org/diseases-conditions/microscopic-colitis/symptoms-causes/syc-20351478
Crohn’s and Colitis Foundation. n.d. What is Microscopic Colitis? https://www.crohnscolitisfoundation.org/what-is-microscopic-colitis#aboutmc
