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Microscopic colitis: a diagnosis to consider

S Hamid1, W Jafri, Z Abbas

  • 1Department of Medicine, Aga Khan University Hospital, Karachi.

JPMA. the Journal of the Pakistan Medical Association
|October 1, 1993
PubMed
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Microscopic colitis causes chronic watery diarrhea, appearing normal during colonoscopy. This condition requires consideration in diagnosing persistent diarrhea, especially in developing countries.

Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Microscopic colitis is characterized by chronic watery diarrhea.
  • Diagnosis relies on colonic biopsy showing inflammation, as endoscopic and radiological exams are normal.

Purpose of the Study:

  • To identify and characterize patients with microscopic colitis presenting with chronic diarrhea.
  • To evaluate the diagnostic challenges and potential treatments for microscopic colitis.

Main Methods:

  • Retrospective review of 215 patients with chronic diarrhea over three years.
  • Inclusion of 19 patients where two pathologists confirmed chronic inflammation on colonic biopsies.
  • Exclusion of other causes through stool examination, laboratory tests, and imaging.

Main Results:

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  • All 19 patients presented with watery diarrhea and urgency.
  • Standard diagnostic tests including colonoscopy were normal in all cases.
  • Most patients did not respond to conventional treatments, with one showing improvement on salazopyrin.

Conclusions:

  • Microscopic colitis should be considered in the differential diagnosis of chronic diarrhea, particularly when other causes are ruled out.
  • In developing countries, where chronic diarrhea is often attributed to infection, microscopic colitis diagnosis is crucial.
  • Further research into effective treatments for microscopic colitis is warranted.