What is it?

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
Microscopic colitis can cause recurrent symptoms. It is possible for the symptoms to resolve on their own.


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.


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
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.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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