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Microscopic colitis: an unfamiliar but treatable disease
E J van der Wouden1, A Karrenbeld, J H Kleibeuker
1Department of Gastroenterology, Isala Clinics, Zwolle, the Netherlands. e.j.van.der.wouden@isala.nl
The Netherlands Journal of Medicine
|March 21, 2009
Summary
Microscopic colitis causes chronic diarrhoea in 10% of cases and is increasingly common. Diagnosis requires colonoscopy with biopsies; budesonide is the recommended first-line treatment for this condition.
Area of Science:
- Gastroenterology
- Histopathology
Background:
- Chronic diarrhoea is a common clinical presentation.
- Microscopic colitis accounts for 10% of chronic diarrhoea cases, with rising prevalence.
- Diagnosis necessitates colonoscopy and biopsies; sigmoidoscopy is inadequate.
Observation:
- Microscopic colitis presents in two histopathological subtypes: collagenous colitis and lymphocytic colitis.
- Budesonide is supported by robust evidence as a first-line therapy.
- Bismuth is also recommended but faces availability challenges in some regions.
Findings:
- Budesonide demonstrates efficacy as a primary treatment for microscopic colitis.
- Limited evidence supports the effectiveness of alternative therapies.
Implications:
- Accurate diagnosis of microscopic colitis is crucial for effective management.
- Budesonide should be considered the preferred initial therapeutic option.
- Further research is needed to evaluate other treatment options for microscopic colitis.
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