Microscopic colitis has emerged as an increasingly common cause of chronic and debilitating watery diarrhea in the adult population. Although it was initially assumed to be a histopathologic diagnosis, recent review of literature shows specific endoscopic features that are associated with it. We report two cases of collagenous colitis that had evidence of rectal ulceration on colonoscopy. Both of these cases were seen in Caucasian females in their 60s in association with the use of selective serotonin reuptake inhibitors. This is followed by a review of literature on the subject. Further studies are needed to assess an association of medications with macroscopic findings observed in patients with microscopic colitis.
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