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Clinical features of microscopic colitis in a nation-wide follow-up study in Iceland
Olafur A Sveinsson1, Kjartan B Orvar, Sigurbjorn Birgisson
1Department of Medicine, Division of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland.
Objective:
The long-term natural history of collagenous colitis (CC) and lymphocytic colitis (LC) is not well known. The few reports available that address these issues have a limited follow-up. The aims of this study were to evaluate the natural history of microscopic colitis (MC), to describe the treatment medications prescribed and to assess the use of non-steroidal anti-inflammatory drugs (NSAIDs) in MC.
Material And Methods:
This study is based on an earlier epidemiological study conducted in Iceland where 125 patients with MC (71 with CC and 54 with LC) were diagnosed in the period 1995-99. All patients still alive and available were questioned about symptoms, treatment and NSAID use in the 3 months preceding the interview.
Results:
In a mean follow-up time of 6.4 years from diagnosis, 15% of the patients had diarrhoeal symptoms more than once a week, 30% less than once a week and 55% had no diarrhoea. Abdominal pain was reported in 18% of the patients. There was no statistically significant difference in symptoms of CC and LC patients. Forty-eight patients (50%) were receiving medication for MC, 16% used aminosalicylates and 14% corticosteroids. Patients using medication for MC had significantly more diarrhoeal symptoms compared with those who did not (p = 0.002). Patients using NSAIDs regularly or as required, statistically did not have more symptoms related to MC than non-NSAID users.
Conclusions:
Only a minority of patients with MC had diarrhoea more than once a week in a long-term follow-up and the symptom pattern was similar between CC and LC patients. The use of NSAIDs was not associated with more diarrhoeal symptoms.
Insights
Microscopic colitis (MC) patients experienced infrequent diarrhea long-term. Non-steroidal anti-inflammatory drug (NSAID) use did not worsen symptoms in collagenous colitis (CC) or lymphocytic colitis (LC) patients.
Area of Science:
- Gastroenterology
- Internal Medicine
- Epidemiology
Background:
- The long-term prognosis and natural history of microscopic colitis (MC), including collagenous colitis (CC) and lymphocytic colitis (LC), remain incompletely understood.
- Existing studies on MC often have limited follow-up periods, hindering comprehensive understanding of disease progression and management.
Purpose of the Study:
- To investigate the long-term natural history of microscopic colitis (MC).
- To document the types of medications prescribed for MC management.
- To evaluate the association between non-steroidal anti-inflammatory drug (NSAID) use and symptom severity in MC patients.
Main Methods:
- A cohort of 125 MC patients (71 CC, 54 LC) diagnosed between 1995-1999 in Iceland was re-evaluated.
- A mean follow-up of 6.4 years was achieved, with surviving patients interviewed about current symptoms, treatments, and NSAID usage.
Main Results:
- After a mean follow-up of 6.4 years, 55% of MC patients reported no diarrhea, 30% less than weekly, and 15% more than weekly.
- Abdominal pain was reported by 18% of patients. No significant symptom differences were observed between CC and LC.
- Fifty percent of patients were on MC medication; NSAID use was not statistically linked to increased diarrheal symptoms.
Conclusions:
- A minority of microscopic colitis patients experience frequent diarrhea in the long term, with similar symptom patterns in collagenous colitis and lymphocytic colitis.
- Non-steroidal anti-inflammatory drug use does not appear to exacerbate symptoms in patients with microscopic colitis.
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