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Microscopic colitis: an update.

Darrell S Pardi1

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA. pardi.darrell@mayo.edu

Inflammatory Bowel Diseases
|January 1, 2005
PubMed
Summary
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Microscopic colitis, a common cause of chronic diarrhea, presents with normal-appearing colonic tissue during endoscopy. Diagnosis relies on identifying intraepithelial lymphocytosis and specific inflammatory infiltrates.

Area of Science:

  • Gastroenterology
  • Histopathology

Background:

  • Microscopic colitis is an emerging cause of chronic diarrhea, abdominal pain, and weight loss.
  • Endoscopic examination of the colon often reveals normal or near-normal mucosa.
  • Diagnosis requires specific histological findings in the appropriate clinical context.

Purpose of the Study:

  • To summarize the key features of microscopic colitis.
  • To differentiate between its subtypes.
  • To discuss diagnostic criteria and therapeutic approaches.

Main Methods:

  • Histopathological examination of colonic biopsies.
  • Clinical correlation of symptoms and endoscopic findings.
  • Review of proposed pathophysiologic mechanisms and treatment outcomes.

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Main Results:

  • Microscopic colitis is characterized by intraepithelial lymphocytosis and lamina propria inflammation.
  • The two main subtypes, collagenous and lymphocytic colitis, are distinguished by a thickened subepithelial collagen band.
  • No single unifying pathophysiologic mechanism has been established.

Conclusions:

  • Microscopic colitis diagnosis relies on histology despite normal endoscopic appearance.
  • Subtypes share clinical and histological similarities, differentiated by collagen band presence.
  • While treatment lacks extensive controlled trials, a systematic approach often manages symptoms effectively.