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Related Experiment Videos

Lansoprazole-associated microscopic colitis: a case series.

Robert D Thomson1, Lisa S Lestina, Steven P Bensen

  • 1Department of Pathology, Veterans Administration Medical Center, Dartmouth Medical School, White River Junction, Vermont 05001, USA.

The American Journal of Gastroenterology
|November 12, 2002
PubMed
Summary
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Proton pump inhibitor lansoprazole may cause microscopic colitis, leading to chronic diarrhea. Discontinuing lansoprazole resolved symptoms and normalized colon histology in patients.

Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Proton pump inhibitors (PPIs) like lansoprazole are widely used for acid-related disorders.
  • Lansoprazole is generally well-tolerated, with diarrhea being a common side effect.
  • A formulary change prompted conversion of omeprazole to lansoprazole in 850 veterans.

Observation:

  • Several patients developed chronic watery diarrhea after switching to lansoprazole.
  • Symptoms included 3-10 daily loose, nonbloody bowel movements and abdominal cramping.
  • Endoscopic evaluation showed normal colonic mucosa in six patients.

Findings:

  • Random biopsies revealed microscopic colitis in all six patients (five lymphocytic, one collagenous).
  • Discontinuation of lansoprazole led to complete symptom resolution within 4-10 days.

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  • Follow-up biopsies confirmed normalization of colonic histology.

    • Implications:

    • This case series suggests a clinical and histological correlation between lansoprazole and microscopic colitis.
    • Lansoprazole should be considered a potential cause of drug-induced microscopic colitis.
    • Further research is warranted to elucidate the mechanism and prevalence.