Microscopic Colitis: Considerations for Gastroenterologists, Endoscopists, and Pathologists

Kotze, Lorete Maria da Silva; Kotze, Paulo Gustavo; Kotze, Luiz Roberto; Nisihara, Renato

doi:10.1590/s0004-2803.20230222-143

Cited by 2 publications

(4 citation statements)

References 22 publications

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“…The physician's suspicion of MC must be communicated to the endoscopist (27) . The incidence of MC is increasing worldwide, therefore primary care professionals and/or gastroenterologists must be aware of this overlooked condition.…”

Section: Discussionmentioning

confidence: 99%

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Warning to Delay in Diagnosing Microscopic Colitis in Older Adults. A Series of Cases

KOTZE,

SOUZA

et al. 2024

Arq. Gastroenterol.

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Background: Microscopic colitis (MC) is a chronic inflammatory bowel disease causing non-bloody diarrhea, and several cases are undiagnosed as a hidden cause of chronic diarrhea. Objective: We aimed to report the symptoms, delay diagnosis and the treatment of MC in a case series. Methods: All patients were treated at a Gastroenterology reference office from May 2022 to June 2023. Personal history including preexisting disorders, use of medications and smoking habits were collected. The delay between the onset of symptoms and the correct diagnosis was informed. All patients consented to use budesonide MMX (Corament®) off label. Results: During the study period, six Caucasoid patients were diagnosed with MC, five females and one male, between the ages of 65 and 74. All patients had comorbities and were taking multiple prescription drugs. Laboratory findings showed negative serology for celiac disease for all patients, normal levels of albumin and vitamin B12. The delay between the symptoms and the MC diagnosis varied from 2 months to 6 years. All patients had a previous diagnosis of irritable bowel syndrome. All patients were in complete clinical remission during the treatment and referred no side effects of the drug. Conclusion: Older females using high-risk medications are suggestive of MC. Preventing delay in the diagnosis of MC is crucial to improvement in patients´ quality of life. Budesonide MMX appears to be effective, safe and well-tolerated.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of MC is increasing worldwide, therefore primary care professionals and/or gastroenterologists must be aware of this overlooked condition. More colonoscopies with biopsies to distinguish MC from IBS are necessary to increase diagnosis (2,3,7,27) .…”

Section: Discussionmentioning

confidence: 99%

Warning to Delay in Diagnosing Microscopic Colitis in Older Adults. A Series of Cases

KOTZE,

SOUZA

et al. 2024

Arq. Gastroenterol.

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“…This approach is essential since mucosal inflammation may not always be apparent during colonoscopy. However, it is important to highlight that there are certain nonspecific macroscopic signs of colitis, which might be indicative of the presence of underlying MC [5]. These signs include a slightly swollen mucosa, friability, exudative lesions, and hyperemic bowel wall [5,52].…”

Section: Diagnosismentioning

confidence: 99%

“…The clinical feature of MC is nonspecific and includes mainly a history of chronic watery, nonbloody diarrhea along with other gastrointestinal symptoms [1,[4][5][6]. The disease course and severity range from mild intermittent symptoms to more progressive and chronic symptoms with dehydration and electrolyte derangement requiring hospitalization and proper management.…”

Section: Introductionmentioning

confidence: 99%

Microscopic Colitis: A Review Article

AlHussaini

2023

Cureus

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Microscopic colitis (MC) is a chronic inflammatory disease that affects the older population. Its clinical presentation includes a variety of gastrointestinal manifestations. The main symptom is chronic watery, nonbloody diarrhea. The disease has a female predominance. The diagnosis might be challenging since the symptoms are similar to other differential diagnoses, such as celiac disease, irritable bowel syndrome, Crohn's disease, bacterial overgrowth, and infectious colitis. The golden diagnostic tool for diagnosis is performing colonoscopy to obtain the colonic biopsy, which demonstrates the characteristic histological evidence needed for diagnosis. The treatment starts with an accurate diagnosis and trial of any possible offending medications. Alternatively, there are many medications, such as bismuth or budesonide, which are very effective in treating this disease. The primary objective of this detailed review is to enhance knowledge and understanding of this condition among healthcare providers to guide them with detailed information regarding epidemiology, clinical presentation, diagnosis, and appropriate management. In the assessment of individuals presenting with persistent chronic diarrhea, it is essential for healthcare providers to consider MC as a probable differential diagnosis.

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Microscopic Colitis: Considerations for Gastroenterologists, Endoscopists, and Pathologists

Cited by 2 publications

References 22 publications

Warning to Delay in Diagnosing Microscopic Colitis in Older Adults. A Series of Cases

Warning to Delay in Diagnosing Microscopic Colitis in Older Adults. A Series of Cases

Microscopic Colitis: A Review Article

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