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Risk Factors for Microscopic Colitis: A Systematic Review and Meta-Analysis
Anett Rancz1,2, Brigitta Teutsch1,3,4, Mahmoud Obeidat1,3
1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Journal of Gastroenterology and Hepatology
|July 17, 2025
Summary
This study found that nonsteroidal anti-inflammatory drugs (NSAIDs) and statins increase microscopic colitis (MC) risk. Proton pump inhibitors and smoking were associated with MC only when using random controls.
Area of Science:
- Gastroenterology
- Epidemiology
- Pharmacology
Background:
- Microscopic colitis (MC) is frequently underdiagnosed due to its reliance on histological diagnosis.
- There is a need for consistent data on risk factors associated with MC.
Purpose of the Study:
- To systematically review and meta-analyze existing literature to identify risk factors for microscopic colitis.
- To address the scarcity and inconsistency of data regarding MC etiology.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Cochrane databases.
- Meta-analysis of cohort, case-control, and cross-sectional studies was performed using a random-effect model.
- Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess risk associations.
Main Results:
- Meta-analysis of 45 studies revealed increased odds of MC with nonsteroidal anti-inflammatory drug (NSAID) and statin use.
- Proton pump inhibitor (PPI) use showed an association with MC only when random controls were used.
- Smoking (current and past) was associated with increased MC risk when compared to random controls, but not histological controls.
Conclusions:
- NSAID and statin use are associated with a higher risk of microscopic colitis.
- The association of PPIs and smoking with MC risk is dependent on the type of control group used in studies.
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