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P Rivière¹, F Zerbib¹

¹Service d'Hépato-gastroentérologie et Oncologie digestive, Centre Médico-chirurgical Magellan, CHU de Bordeaux, 33600 Pessac, France.

La Revue De Medecine Interne

|July 18, 2020

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Microscopic colitis, a cause of chronic watery diarrhea, often affects postmenopausal women and can be linked to medications. Budesonide is a key treatment, aiming for remission to improve quality of life.

Area of Science:

Gastroenterology
Internal Medicine

Background:

Microscopic colitis is a significant cause of chronic watery diarrhea, particularly in postmenopausal women.
Approximately 50% of cases are associated with medication side effects, including NSAIDs and PPIs.

Purpose of the Study:

To outline the diagnostic and management strategies for microscopic colitis.
To emphasize achieving clinical remission and improving patient quality of life.

Main Methods:

Diagnosis requires colonic biopsies from multiple locations.
Initial management involves avoiding iatrogenic factors and smoking, alongside symptomatic treatment for diarrhea.

Main Results:

Budesonide is the primary treatment for treatment failure or severe symptoms, with the goal of achieving clinical remission (less than 3 liquid stools/day).

Keywords:

Colite collagène Colite lymphocytaire Colite microscopique Collagenous colitis Lymphocytic colitis Microscopic colitis

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Diarrhea recurrence is common after budesonide treatment, often necessitating maintenance therapy.

Second-line therapies, including immunosuppressants, biologics, or surgery, are considered for refractory or intolerant cases.

Conclusions:

Effective management of microscopic colitis focuses on budesonide therapy for remission and quality of life improvement.
Recurrence is frequent, requiring potential maintenance or second-line treatments discussed in a multidisciplinary setting.