Description

Microscopic Colitis is swelling and irritation, called inflammation of the large intestine. This large intestine, also called the colon. Microscopic Colitis causes symptoms of watery diarrhea.

The condition gets its name from the necessity of searching in the colon tissue under a microscope to diagnose it. The tissue appears typical in the screening with a colonoscopy or flexible sigmoidoscopy.

There are two subtypes of microscopic colitis:

  • Colitis, collagenous , in which a thick layer of protein called collagen grows in the colon tissue.
  • Lymphocytic Colitis , in which the white blood cells, called lymphocytes, an increase in the tissue of the colon.

The researchers believe collagen (kuh-LAYJ-uh-nus) colitis and lymphocytic colitis may be forms of the same condition. Symptoms, testing and treatment are the same for both subtypes.

Symptoms

The symptoms of microscopic colitis include:

  • The watery diarrhea.
  • Abdominal pain, cramping or bloating.
  • The loss of weight.
  • Nausea.
  • Not be able to control the movements of the intestine, called fecal incontinence.
  • The body doesn't have enough water, called dehydration.

The symptoms of microscopic colitis that come and go. Sometimes, the symptoms improve on their own.

When to see a doctor

If you have diarrhea that lasts more than a couple of days, contact your health care professional to diagnose and treat your condition.

Causes

It is not clear what causes the inflammation and irritation, the so-called inflammation of the colon are found in microscopic colitis. The researchers believe that the causes may include:

  • Medications that can inflame the lining of the colon.
  • Bile acids are not absorbed as it should be which inflames the lining of the colon.
  • The bacteria that produce toxins or viruses that interact with the lining of the colon.
  • Autoimmune disease linked to the microscopic colitis, such as rheumatoid arthritis, celiac disease and psoriasis. Autoimmune disease that occurs when the body's immune system attacks healthy tissues.

Risk factors

Risk factors for microscopic colitis include:

  • Age. Microscopic Colitis is more common in people older than 50 years of age.
  • Sex. Women are more likely to have microscopic colitis than men. Some studies suggest a relationship between post-menopausal hormone therapy and microscopic colitis.
  • Autoimmune disease. People with microscopic colitis, sometimes, they also have an autoimmune disorder, such as celiac disease, thyroid disease, rheumatoid arthritis, type 1 diabetes or psoriasis.
  • Genetic link. The research suggests that there may be a link between microscopic colitis and a family history of irritable bowel syndrome.
  • The habit of smoking. Recent research studies have demonstrated a link between the consumption of tobacco and microscopic colitis, especially in people with ages between 16 and 44 years.

Some studies show a link between the use of certain medications can increase the risk of microscopic colitis. But not all studies are in agreement.

Medications that may be linked to the condition include:

  • Pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).
  • The-pump inhibitors, including lansoprazole (Prevacid), esomeprazole (Nexium), pantoprazole (Protonix), rabeprazole (Aciphex), omeprazole (Prilosec) and dexlansoprazole (Dexilant).
  • Selective serotonin reuptake inhibitors (Ssris) such as sertraline (Zoloft).
  • Acarbose.
  • Flutamide.
  • Ranitidine.
  • Carbamazepine (Carbatrol, Tegretol, others).
  • Clozapine (Clozaril, Versacloz).
  • Entacapone (Comtan).
  • Paroxetine (Paxil).
  • Simvastatin (Flolipid, Zocor).
  • Topiramate (Topamax, Qsymia, other).

Complications

There is a minimum of complications for the majority of the people once microscopic colitis is treated with success. The condition of not increasing the risk of colon cancer.

Diagnosis

A complete clinical history, physical examination, and testing can help determine if other conditions, such as celiac disease, may be the cause of the diarrhea. Your healthcare provider will also ask about the medicines that you take.

Tests

To help confirm a diagnosis of microscopic colitis, you may have one or more of the following tests and procedures:

  • Colonoscopy and biopsies.The exam allows a health care professional to see the entire colon using a thin, flexible, lighted tube with an attached camera called a colonoscope. The camera sends images of your rectum and the entire colon to a monitor. This lets the healthcare provider see the lining of the bowel. The health care professional also can put instruments through the tube to take a tissue sample, called a biopsy, to study under a microscope.
  • Flexible sigmoidoscopy.This procedure is similar to a colonoscopy. But instead of showing the entire colon, a flexible sigmoidoscopy lets your health care professional to see inside the rectum and most of the sigmoid colon. This is about the length of 1 to 2 feet (30 to 60 centimeters) of the large intestine. The health care provider uses a thin, lighted tube, called a sigmoidoscope, to search in the intestinal lining. A tissue sample is taken through the scope during the exam to look for microscopic colitis.

Colonoscopy and biopsies. The exam allows a health care professional to see the entire colon using a thin, flexible, lighted tube with an attached camera called a colonoscope. The camera sends images of your rectum and the entire colon to a monitor. This lets the healthcare provider see the lining of the bowel.

The health care professional also can put instruments through the tube to take a tissue sample, called a biopsy, to study under a microscope.

Flexible sigmoidoscopy. This procedure is similar to a colonoscopy. But instead of showing the entire colon, a flexible sigmoidoscopy lets your health care professional to see inside the rectum and most of the sigmoid colon. This is about the length of 1 to 2 feet (30 to 60 centimeters) of the large intestine.

The health care provider uses a thin, lighted tube, called a sigmoidoscope, to search in the intestinal lining. A tissue sample is taken through the scope during the exam to look for microscopic colitis.

Intestinal tissues often appear typical in microscopic colitis. So that a sample of tissue from the colon, called a biopsy, taken during a colonoscopy or flexible sigmoidoscopy is required to confirm a diagnosis.

In both subtypes of microscopic colitis, the cells in the tissue of the colon can be seen under the microscope to make a diagnosis.

Other tests

In addition to a colonoscopy or flexible sigmoidoscopy, you may have one or more of these tests to rule out other causes of your symptoms.

  • Stool sample of study to help rule out infection as a cause of diarrhea.
  • Blood test to look for signs of anemia or celiac disease.
  • Endoscopy with biopsy to rule out celiac disease. Health professionals use a long, thin tube with a camera on the end to look in the upper digestive tract. You can remove a sample of tissue, called a biopsy, for study in a laboratory.

Treatment

Microscopic Colitis can improve on their own. But when the symptoms are severe or do not go away, you may need treatment to relieve them. The health care professionals most often start with the most simple of the treatments that are least likely to cause side effects.

The diet and the suspension of certain medications

The treatment usually begins with changes in the diet and medicines that can help relieve diarrhea. Your health care professional may suggest that you:

  • Eating a low-fat, low-fiber diet. Foods that have less fat and are low in fiber can help to relieve diarrhea in the short term. But this diet can not help with microscopic colitis in the long term.
  • Limit dairy products, gluten, caffeine and sugar. These foods can make your symptoms worse.
  • Stop taking any medication that might be a cause of your symptoms. You may have to switch to another medication to treat a condition.

Drugs

If you are still having symptoms, your health care professional may suggest:

  • Anti-diarrheal medicines such as loperamide (Imodium) or bismuth subsalicylate (Pepto-Bismol).
  • Steroids , such as budesonide (Entocort EC, Ortikos, other).
  • Medications that block the bile acids, such as cholestyramine/aspartame or cholestyramine (Locholest, Prevalite) or colestipol (Colestid).
  • Medications that suppress the immune system to help reduce the swelling and irritation in the colon, such as mercaptopurine (Purinethol) and azathioprine (Azasan, Imuran).
  • The biological drugs, such as infliximab (Remicade), adalimumab (Humira) or vedolizumab (Entyvio). These can reduce the swelling and irritation in the colon.

Surgery

Very rarely, when the symptoms of microscopic colitis are severe and the drugs don't work, your doctor may suggest surgery to remove all or part of the colon.

Lifestyle and home remedies

Changes to your diet can help relieve diarrhea of microscopic colitis. Try:

  • Drink plenty of fluids. The water is best, but the liquid with the addition of sodium and potassium, called electrolytes, can also help. Try to drink broth or diluted fruit juice. Do not drink beverages that are high in sugar or sorbitol, or that contain alcohol or caffeine, such as coffee, tea, and cola. These can make your symptoms worse.
  • Soft, easy to digest food. These include applesauce, bananas, melons, and rice. Do not eat foods that are rich in fiber, such as legumes and nuts. Eat only cooked vegetables. If you think that your symptoms are improving, gradually add high-fiber foods back to your diet. Talk with your healthcare provider about how long you should continue with this type of diet.
  • Eat several small meals instead of a few large meals. Spacing meals throughout the day can relieve diarrhea.
  • Avoid irritating foods. Stay away from spicy, fatty, or fried foods and other foods that make your symptoms worse.

Preparing for your appointment

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of any thing that you should not do before your appointment. This might include eating solid foods on the day before your appointment.
  • Write down your symptoms, including when they started and how they have changed or worsened with time.
  • Make a list of all your medications, vitamins or supplements, including doses.
  • Write down your key medical information, including other conditions. Also keep in mind, if you have been in a hospital in the last few months.
  • Write down key personal information, including any recent changes or stressors in your life. Include the details of your daily diet, even if you normally use caffeine and alcohol.
  • Write questions to ask their health professional.

Questions to ask your doctor

Some basic questions to ask your health care professional include:

  • What is the most likely cause of my condition?
  • Do you think my condition is going to disappear or the last?
  • What kinds of tests do I need?
  • What treatments can help?
  • There are other medical problems may I have that are linked to the microscopic colitis?
  • If I need surgery, what will my recovery be like?
  • There are foods and drinks should I avoid? I was going to change my diet help?

Don't hesitate to ask any questions at any time you do not understand something.

What to expect from your doctor

Your healthcare provider is likely to ask you:

  • When did your symptoms begin?
  • The symptoms been constant or come and go?
  • How many loose stools you are going to have it every day?
  • How serious are other symptoms, such as abdominal cramps and nausea?
  • There has been blood in the stool?
  • Have you lost weight?
  • Have you traveled recently?
  • Is someone sick at home with diarrhea?
  • Have you ever been in a hospital or taken antibiotics in the last few months?
  • Is there something that will make your diarrhea worse, such as certain foods?
  • What medications are you taking? Did you start taking any in the weeks before the diarrhea started?
  • What do you eat in a typical day?
  • Does the use of caffeine or alcohol? How much?
  • Do you have celiac disease? If so, you eat a gluten-free diet?
  • Do you have diabetes or thyroid disease?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?

What you can do in the meantime

You can find a bit of relief of the diarrhea by making changes in your diet:

  • Eat bland, low-fat foods.
  • You do not have dairy products, spicy foods, caffeine and alcohol.
Symptoms and treatment of Microscopic colitis