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Related Experiment Videos

Microscopic colitis: a missed diagnosis?

Ole Haagen Nielsen1, Ben Vainer, Ove B Schaffalitzky de Muckadell

  • 1Department of Gastroenterology C, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark. ohn@dadlnet.dk

Lancet (London, England)
|December 8, 2004
PubMed
Summary
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Microscopic colitis, including collagenous colitis and lymphocytic colitis, is more common than previously thought. Increased awareness among clinicians and pathologists is crucial for diagnosing this condition in patients with watery diarrhea.

Area of Science:

  • Gastroenterology
  • Pathology
  • Epidemiology

Background:

  • Microscopic colitis, encompassing collagenous colitis and lymphocytic colitis, was historically considered rare.
  • Recent data indicate these conditions are more prevalent than previously recognized.
  • Persistent watery, non-bloody diarrhea necessitates awareness of microscopic colitis by gastroenterologists and pathologists.

Purpose of the Study:

  • To determine the epidemiological incidence of microscopic colitis in a defined population.
  • To highlight the diagnostic challenges and prevalence of missed diagnoses in microscopic colitis.
  • To inform clinicians and pathologists about the commonality of microscopic colitis.

Main Methods:

  • Analysis of colonic biopsy specimens from 1018 patients undergoing colonoscopy for non-bloody diarrhea.

Related Experiment Videos

  • Review of histological evaluations for microscopic colitis diagnoses.
  • Epidemiological study in a well-defined Swedish population.

    • Main Results:

    • Microscopic colitis was diagnosed in 9.5% (97/1018) of patients with non-bloody diarrhea.
    • Approximately one-third of microscopic colitis cases were initially missed in histological evaluations.
    • Median age at diagnosis was 64 years for collagenous colitis and 59 years for lymphocytic colitis.
    • The incidence of microscopic colitis approaches that of ulcerative colitis.

    Conclusions:

    • Microscopic colitis is a common gastrointestinal disorder, particularly in elderly females presenting with watery diarrhea.
    • Increased clinical and pathological awareness is essential for accurate diagnosis.
    • Development and evaluation of novel therapeutic strategies are needed due to potentially disabling symptoms.