Related Experiment Videos
Diagnosis and management of microscopic colitis
1Division of Gastroenterology, University of Calgary, Alberta.
Canadian Family Physician Medecin De Famille Canadien
|December 3, 2003
Summary
Microscopic colitis (MC) is a common cause of chronic watery diarrhea in older adults. Diagnosis requires colonic biopsy, followed by a stepwise treatment approach starting with antidiarrheals and progressing to other therapies if needed.
Area of Science:
- Gastroenterology
- Histopathology
Background:
- Microscopic colitis (MC) is a significant cause of chronic diarrhea, particularly in middle-aged and elderly populations.
- It presents as watery diarrhea with normal endoscopic and radiologic findings.
Purpose of the Study:
- To outline the diagnosis and management of microscopic colitis.
- To propose a stepwise therapeutic strategy for MC.
Main Methods:
- Literature review of MEDLINE from January 1996 to August 2002.
- Inclusion of well-designed retrospective studies and reviews due to the rarity of controlled trials.
Main Results:
- Microscopic colitis, encompassing collagenous and lymphocytic forms, is characterized by specific histologic findings on colonic biopsy.
- A stepwise treatment approach is recommended, beginning with antidiarrheal agents, followed by bismuth subsalicylates and budesonide, then cholestyramine and 5-aminosalicylic acid agents.
- Refractory cases may require oral corticosteroids, immunomodulatory therapy, or colectomy as a last resort.
Conclusions:
- Microscopic colitis is a key contributor to chronic diarrhea.
- A structured, stepwise management plan is essential for effective treatment after diagnosis.