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Microscopic colitis refers to two related medical conditions which cause diarrhea: collagenous colitis and lymphocytic colitis. [ 2 ] [ 3 ] Both conditions are characterized by the presence of chronic non-bloody watery diarrhea , normal appearances on colonoscopy and characteristic histopathology findings of inflammatory cells.
Like the 1995–1999 Olmsted County study and the 1995–1999 Icelandic study, this Danish study found a heavy increase in rates of collagenous colitis and microscopic colitis overall during the studied period, with the incidence rates in 2001 and 2016 for microscopic colitis found to be, respectively, 2.3 and 24.3 cases per 100,000 person-years.
No definite cause has been determined. The peak incidence of lymphocytic colitis is in persons over age 50; the disease affects twice as many women as men. [3] Some reports have implicated long-term usage of NSAIDs, proton pump inhibitors, and selective serotonin reuptake inhibitors, and other drugs.
In these cases, a diagnosis of indeterminate colitis may be made. [ 66 ] Irritable bowel syndrome can present with similar symptoms as either disease, as can nonsteroidal anti-inflammatory drug (NSAID) enteritis and intestinal tuberculosis .
What causes microscopic colitis and who gets it? It occurs in males and females of all ages, but women are more likely to be affected and it mostly presents later in adulthood.
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Crohn's disease – also known as regional enteritis, it can occur along any surface of the gastrointestinal tract. The most common location for Crohn's disease to manifest, with or without the involvement of the colon or other parts of the GI tract, is in the terminal ileum (the final segment of the small intestine). [5]
Less common causes of this symptom profile are carcinoid syndrome, microscopic colitis, bacterial overgrowth, and eosinophilic gastroenteritis; IBS is, however, a common presentation, and testing for these conditions would yield low numbers of positive results, so it is considered difficult to justify the expense. [75]