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Controversials of Microscopic Colitis.

Emese Mihaly1, Árpád Patai1, Zsolt Tulassay1

  • 1Gastroenterology Unit, Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary.

Frontiers in Medicine
|October 29, 2021
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Summary
This summary is machine-generated.

Microscopic colitis (MC) incidence is rising, nearing inflammatory bowel disease (IBD) rates. This review highlights unanswered questions regarding MC pathogenesis, diagnosis, and treatment, calling for further research.

Keywords:
collagenous colitisincomplete microscopic colitislymphocytic colitismicroscopic colitisnatural course

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Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Microscopic colitis (MC) incidence is increasing, approaching that of inflammatory bowel disease (IBD).
  • Despite increased awareness, significant controversies persist regarding MC pathogenesis, diagnosis, and treatment.
  • Key unanswered questions include the role of microbiome changes, subtype transformations, and the link between MC and IBD.

Purpose of the Study:

  • To summarize current data on microscopic colitis (MC).
  • To highlight persistent controversies and knowledge gaps in MC pathogenesis, diagnosis, and therapy.
  • To stimulate future research into the unresolved aspects of MC.

Main Methods:

  • Mini-review of existing data on microscopic colitis.
  • Synthesis of information on pathogenesis, diagnosis, and therapy.
  • Identification of controversial aspects and areas requiring further investigation.

Main Results:

  • MC incidence is rising, with increasing recognition.
  • The relationship between MC and IBD, microbiome role, and subtype dynamics remain unclear.
  • Etiology of incomplete MC and its natural course are not well understood.

Conclusions:

  • Budesonide is effective for MC but has a high relapse rate, prompting questions about biologic efficacy.
  • The association with celiac disease suggests potential shared pathogenetic mechanisms.
  • Further research is crucial to address the many remaining questions in MC.