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A Literature Review of Microscopic Colitis
Ahmed Pervez1, Khurram Siddique1, Muhammad Amir Saeed Khan1
1General and Colorectal Surgery, Royal Oldham Hospital, Northern Care Alliance NHS Foundation Trust, Oldham, GBR.
Microscopic colitis (MC) diagnosis and treatment face challenges due to uncertainties. This review addresses knowledge gaps, controversies in MC subtypes, pathogenesis, and management, highlighting budesonide-refractory cases.
Area of Science:
- Gastroenterology
- Immunology
Background:
- Microscopic colitis (MC) is increasingly recognized but poorly understood.
- Current data on MC is limited by uncertainties, leading to misclassification issues.
Purpose of the Study:
- To review current knowledge gaps and controversies surrounding microscopic colitis.
- To discuss challenges in MC subtypes, pathogenesis, and management strategies.
Main Methods:
- Literature review of recent data on microscopic colitis.
- Analysis of diagnostic criteria, including histology and immunohistopathology.
- Examination of proposed etiopathogenesis and treatment outcomes.
Main Results:
- Histology and immunohistopathology differentiate MC subtypes, but transitional forms cause misclassification.
- The increased incidence of MC lacks a clear explanation; multifactorial etiopathogenesis with immune involvement is suggested.
- Budesonide is effective for most MC cases, but budesonide-refractory MC poses a significant challenge.
Conclusions:
- Further research is needed to clarify MC pathogenesis and its potential link to irritable bowel disease.
- Immunomodulators and biologics are considered second-line treatments for budesonide-refractory microscopic colitis.
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