Understanding Microscopic colitis: Causes, Symptoms, and Management

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Microscopic colitis

by Alike Medical Team ∙ Updated on June 13, 2023

General

Microscopic colitis causes persistent watery diarrhea due to inflammation in the large intestine (colon). Detecting the disorder requires examining colon tissue under a microscope because colonoscopy and flexible sigmoidoscopy may show normal tissue. Microscopic colitis can be divided into different types: Collagenous colitis occurs when a thick layer of protein (collagen) forms in the colon White blood cells (lymphocytes) increase in colon tissue in lymphhocytic colitis Mixed collagenous and lymphocytic colitis with incomplete microscopic features.

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Signs & symptoms

Microscopic colitis is characterized by the following signs and symptoms: Watery diarrhea on a regular basis Pain, cramps, or bloating in the abdomen Loss of weight Feeling nauseated Fecal incontinence Dehydration Microscopic colitis can cause recurrent symptoms. It is possible for the symptoms to resolve on their own.

Diagnosis

Getting a complete medical history and physical examination can help determine if there are any other conditions contributing to your diarrhea. You will also be asked about any medications you are taking, particularly aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), proton pump inhibitors, and selective serotonin reuptake inhibitors (SSRIs) that may increase the risk of microscopic colitis. A colon tissue sample (biopsy) obtained during a colonoscopy or flexible sigmoidoscopy is necessary to confirm the diagnosis of microscopic colitis because intestinal issues often appear normal in microscopic colitis.

Treatment

There is a possibility that microscopic colitis will heal by itself. In some cases, however, treatment may be needed to relieve persistent or severe symptoms. Typically, doctors start with the simplest, easiest-to-tolerate treatments, working their way up. Changing your diet and discontinuing your medication Medication to treat diarrhea Steroids Medications that block bile acids Anti-inflammatory medications Medications that suppress the immune system If your symptoms of microscopic colitis are severe and medication is ineffective, your doctor may recommend surgery to remove all or part of your colon. Microscopic colitis rarely requires surgery.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

National Institutes of Health ∙ World Health Organization ∙ MedlinePluse ∙ Centers for Disease Control and Prevention

☝ All information has been reviewed by certified physicians from Alike

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