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Updated: Nov 2, 2025
Fluorescence-mediated Tomography for the Detection and Quantification of Macrophage-related Murine Intestinal Inflammation
Published on: December 15, 2017
Microscopic colitis
Kristin E Burke1,2, Mauro D'Amato3,4, Siew C Ng5
1Gastroenterology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. keburke@mgh.harvard.edu.
Abstract:
Microscopic colitis (MC) is an inflammatory disease of the large intestine associated with urgent watery diarrhoea. MC may occur in people of all ages, although the disease primarily affects older women. Once believed to be rare, MC is now known to be a common cause of chronic watery diarrhoea in high-income countries, affecting 1 in 115 women and 1 in 286 men during their lifetime in Swedish population-based estimates. An inappropriate immune response to disturbances in the gut microenvironment is implicated in the pathogenesis of MC. Evidence also supports an underlying genetic basis for disease. The diagnosis of MC relies on clinical symptoms and microscopic assessment of colonic biopsy samples. MC is categorized histologically into collagenous colitis, lymphocytic colitis and their incomplete forms. The mainstay of treatment includes the use of budesonide, with or without adjunctive therapies, and withdrawal of offending drugs. Emerging studies suggest a role for biologicals and immunosuppressive therapies for the management of budesonide-refractory or budesonide-dependent disease. MC can have a substantial negative effect on patient quality of life. The outlook for MC includes a better understanding of the immune response, genetics and the microbiome in disease pathogenesis along with progress in disease management through robust clinical trials.
Insights
Microscopic colitis (MC) is a common cause of chronic watery diarrhea, primarily affecting older women. Its pathogenesis involves immune responses and genetics, with budesonide as a key treatment.
Area of Science:
- Gastroenterology
- Immunology
- Genetics
Background:
- Microscopic colitis (MC) is an inflammatory bowel disease characterized by urgent watery diarrhea.
- It is a common cause of chronic diarrhea in high-income countries, particularly affecting older women.
- Pathogenesis is linked to immune dysregulation and genetic predisposition.
Purpose of the Study:
- To provide a comprehensive overview of microscopic colitis.
- To discuss its epidemiology, pathogenesis, diagnosis, and management.
- To highlight the impact on quality of life and future research directions.
Main Methods:
- Review of clinical symptoms and microscopic assessment of colonic biopsies.
- Histological categorization into collagenous colitis and lymphocytic colitis.
- Evaluation of treatment strategies including budesonide and emerging therapies.
Main Results:
- MC affects approximately 1 in 115 women and 1 in 286 men in Sweden.
- Diagnosis relies on clinical presentation and biopsy findings.
- Budesonide is the primary treatment, with biologics and immunosuppressants for refractory cases.
Conclusions:
- MC significantly impacts patient quality of life.
- Further research into immune response, genetics, and microbiome is crucial.
- Progress in clinical trials is advancing disease management.
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