Microscopic Colitis

Microscopic colitis is an intestinal inflammatory disease that gains increasing interest among the gastroenterologists. It has been found that microscopic colitis is responsible for many intestinal problems that were previously mistaken for symptoms of the irritable bowel syndrome.


The exact cause of the disease is unknown, microscopic colitis probably belongs among the inflammatory bowel diseases (IBDs) such as Crohn's disease and ulcerative colitis. Similarly to these conditions, microscopic colitis is caused by pathological immune response when the immune system damages our own tissues, in this case the large intestine. The reason of such immune reaction is unclear; we suspect the influence of intestinal contents (possible impact of food and certain medication such as the non-steroidal anti-inflammatory drugs) and specific genetic precondition. The middle-aged women are typically affected patients but the disease occurs also in men.


Microscopic colitis manifests by frequent watery diarrhea. However, blood and mucus in stool is usually not present. The diarrhea is probably caused by a reduced ability of inflamed intestinal mucosa to absorb minerals and water. The patients also complain of flatulence and convulsive abdominal pain. Unlike Crohn's disease and ulcerative colitis, microscopic colitis does not cause extraintestinal complications and it is not related to increased risk of the colon cancer.


Patients with the above mentioned problems are usually examined by a colonoscopy. Microscopic colitis is typical by normally-looking mucosa of the large intestine and the patient may mistakenly get a label of functional digestive problems such as the irritable bowel syndrome. Therefore, it is necessary to take bioptic samples from the healthy-looking mucous membrane, which proves the presence of inflammation. 


The treatment is similar to ulcerative colitis. It is advisable to avoid any food that aggravates the symptoms and regularly use special anti-inflammatory drugs acting in the guts.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources