Macroscopic findings, incidence and characteristics of microscopic colitis in a large cohort of patients from the United Kingdom

Abstract

One in six patients with MC demonstrated distinct macroscopic findings at colonoscopy. Our data confirm a female preponderance in MC, a relatively short symptom duration and use of certain drugs as common features. Both right- and left-sided biopsies were frequently positive, suggesting flexible sigmoidoscopy and biopsy could confirm a diagnosis in certain individuals.

Microscopic colitis: a population‐based case series over a 9‐year period in Northern Ireland

“…One recent Swedish study reported endoscopic abnormalities in 37% of patients with CC and 25% of patients with LC [18]. The frequency of endoscopic abnormality in this study (15%) is very similar to that found in another recent UK study [17]. We accept, however, that recording information on endoscopic appearances from pathology request forms alone may result in incomplete data collection.…”

“…This is the first cohort of patients with MC reported within the Northern Ireland population. We describe a population-representative series of patients with CC and LC whose demographic and clinical features are similar to previously reported larger series from the UK and Ireland [17,24]. Our incidence data for LC are likely to be incomplete, but the average annual incidence of CC (5.0 per 100 000) is similar to that observed in other epidemiological studies from the UK and further afield [2,17].…”

“…Some studies have reported that the histological features of MC, and of CC in particular, are less well developed in the distal colon than in the proximal colon, and therefore proximal colonic sampling is required to confidently exclude a diagnosis of MC [26,27]. This is contradicted by more recent studies which have reported excellent concordance between histology of right and left colonic biopsies in the diagnosis of MC [17,28,29]. Our right and left colonic biopsy concordance rate of 95% supports the latter studies, and suggests that sampling from the left colon will confidently exclude a diagnosis of MC if histology is normal.…”

“…Variation in such endoscopic sampling is well recognized and clarity is required on the optimal sampling technique. Subtle endoscopic abnormalities are also now increasingly being recognized, calling into question the appropriateness of the term 'microscopic colitis' [14][15][16][17][18].…”

Undiagnosed microscopic colitis: a hidden cause of chronic diarrhoea and a frequently missed treatment opportunity

“…Patients with CC, LC and MCi cannot be distinguished from each other based on their demographic features, clinical characteristics or symptom presentation 23–25. Treatment guidelines do not distinguish between CC and LC,9 because differences in treatment outcomes have not been observed between these subgroups 26.…”