Microscopic colitis or functional bowel disease with diarrhea: a French prospective multicenter study

Area of Science:

• Gastroenterology
• Internal Medicine
• Pathology

Background:

• Microscopic colitis (MC), encompassing lymphocytic colitis (LC) and collagenous colitis (CC), is a condition causing chronic diarrhea.
• Differentiating MC from functional bowel disorder with diarrhea (FBD-D) is crucial for appropriate patient management.
• Identifying specific predictors for MC can aid in early diagnosis and intervention.

Purpose of the Study:

• To characterize a cohort of patients diagnosed with microscopic colitis (MC).
• To compare the demographic, clinical, biological, and etiological features of MC patients with those of functional bowel disorder with diarrhea (FBD-D) patients.
• To identify predictors that increase the likelihood of microscopic colitis.

Main Methods:

• A prospective cohort study was conducted across 26 centers in France between September 2010 and June 2012.
• Patients with at least three daily bowel movements for over four weeks and normal colonoscopy were included.
• Demographic, clinical, biological, and etiological data were collected and compared between MC and FBD-D groups using logistic regression analysis.

Main Results:

• The study included 433 patients: 129 with MC (87 LC, 42 CC) and 278 with FBD-D.
• Independent predictors for MC included age over 50 (OR=3.1), nocturnal stools (OR=2), weight loss (OR=2.5), diarrhea duration under 12 months (OR=2.0), recent drug introduction (OR=3.7), and autoimmune disorders (OR=5.5).

Conclusions:

• Age over 50, nocturnal stools, weight loss, recent drug initiation, and a history of autoimmune disease are significant indicators for microscopic colitis.
• These findings highlight the importance of considering these factors when evaluating patients with chronic diarrhea.
• The presence of these predictors warrants a colonoscopy with biopsies for definitive diagnosis of MC.