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Published on: October 16, 2013
Microscopic colitis: a review for the surgical endoscopist
Indraneel Datta1, Savtaj S Brar, Christopher N Andrews
1Division of General Surgery, University of Calgary, Calgary, Alta.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|October 30, 2009
Summary
Microscopic colitis (MC) is a colon inflammation causing chronic diarrhea, often missed during normal colonoscopies. Diagnosis requires biopsy, with treatments ranging from supportive care to medication.
Area of Science:
- Gastroenterology
- Colorectal Diseases
- Inflammatory Bowel Disease
Background:
- Microscopic colitis (MC) is an inflammatory colon condition distinct from Crohn disease or ulcerative colitis.
- It presents with chronic diarrhea, cramping, and bloating, with increasing recent recognition.
- MC affects up to 20% of adults with chronic diarrhea despite a normal-appearing colonoscopy.
Purpose of the Study:
- To highlight the importance of recognizing microscopic colitis in patients with chronic diarrhea.
- To emphasize the diagnostic role of colonic mucosal biopsy in cases with normal endoscopic findings.
- To inform healthcare providers, particularly surgeons performing colonoscopies, about MC.
Main Methods:
- Review of clinical presentation and diagnostic criteria for microscopic colitis.
- Emphasis on histological examination of colonic biopsies for diagnosis.
- Discussion of treatment strategies for microscopic colitis.
Main Results:
- Endoscopic and radiological examinations in MC are typically normal.
- Histology reveals increased lymphocytes in the colonic mucosa, the hallmark of MC.
- Watery, nonbloody diarrhea is the characteristic symptom.
Conclusions:
- Microscopic colitis is an important cause of chronic diarrhea that can be overlooked.
- Mucosal biopsy during colonoscopy is crucial for diagnosing MC in appropriate patients.
- Awareness and targeted biopsy are essential for effective diagnosis and management of MC.
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