Medication Exposure and the Risk of Microscopic Colitis: Results from a Prospective us Trial

Yen, Eugene F.; Yoo, Janet; Ture, Asantewaa; Lapin, Brittany; Bianchi, Laura; Elton, Eric; Goldberg, Michael J.; Gentile, Nicole; Goldstein, Jay L.

doi:10.1016/s0016-5085(17)30958-7

Cited by 3 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…82 , 91–95 , 97–99 The combined use with PPIs might further increase this risk 98 . MC was also associated with SSRI exposure (OR: 2.98, 95% CI: 2.35–3.78, I 2 = 90%) 54,81,82,91–93,95,96,98,99 (see also Supporting Information Appendix ). It should be stressed that different criteria for ‘drug exposure' were applied and different reference populations were considered.…”

Section: Methodsmentioning

confidence: 95%

“…Summary of evidence: Drug‐induced MC was addressed by retrospective case‐control studies 54 , 81 , 82 , 91–100 showing an association with the use of NSAIDs, PPIs and SSRIs. PPI use was strongly associated with MC (OR: 2.95, 95% CI: 1.82–4.80, I 2 = 99%), 54 , 81 , 82 , 91–96 , 98–100 especially when used continuously for 4–12 months (OR: 4.69, 95% CI: 3.58–6.13) 98 . Exposure to NSAIDs was also associated with an increased risk of MC (OR: 2.40, 95% CI: 1.99–2.89, I 2 = 88%) 54 ,.…”

Section: Methodsmentioning

confidence: 99%

“…98 Exposure to NSAIDs was also associated with an increased risk of MC (OR 2.40, 95% CI: 1.99-2.89, I 2 ¼ 88%). 54,82,[91][92][93][94][95][97][98][99] The combined use with PPIs might further increase this risk. 98 MC was also associated with SSRI exposure (OR 2.98, 95% CI: 2.35-3.78, I 2 ¼ 90%) 54,81,82,[91][92][93]95,96,98,99 (see also Appendix D, supplementary material).…”

Section: Very Lowmentioning

confidence: 99%

“…99%),54,81,82,[91][92][93][94][95][96][98][99][100] especially when used continuously for 4-12 months (OR: 4.69, 95% CI: 3.58-6.13) 98. Exposure to NSAIDs was also associated with an increased risk of MC (OR: 2.40, 95% CI:1.99-2.89, I 2 = 88%) 54,82,[91][92][93][94][95][97][98][99]. The combined use with PPIs might further increase this risk 98.…”

mentioning

confidence: 99%

See 3 more Smart Citations

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

View full text Add to dashboard Cite

Introduction Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, non-bloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder. Methods Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method. Results These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice. Conclusion These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

show abstract

Section: Methodsmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Section: Very Lowmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 14 Thus, the condition is at present diagnosed in 119/100,000 inhabitants (95% CI, 73-166), with a slight prevalence of LC over collagenous colitis. 4 Microscopic colitis is more frequent in females than in males, 32 and smoking and drugs are likely additional risk factors, 33 , 34 although a direct cause-effect relation is unproven.…”

Section: Discussionmentioning

confidence: 99%

Is mastocytic colitis a specific clinical-pathological entity?

et al. 2022

View full text Add to dashboard Cite

The number of intestinal mast cells (MC) is increased in several types of colitis, but the mucosa of patients with chronic non-bloody diarrhea has not been studied. The current study sought to determine the relationship between MC counts and degranulation and the severity of symptoms in patients with chronic loose stools. Following a negative laboratory workup for the most common causes of chronic diarrhea, patients with chronic non-bloody loose stools were included in the study. Patients with macroscopic evidence of inflammation or organic disease were excluded after endoscopy with biopsies. Biopsies from the 179 patients in the study were stained with hematoxylin and eosin and anti-CD117 c-kit antibodies. Immunohistochemistry was used to assess the degree of MC degranulation. Out of the 179 patients, 128 had normal histologic findings suggestive of irritable bowel syndrome and were used as controls. Twenty-four presented with abnormally high MC counts (≥40 MC x HPF), 23 with ≥20 intraepithelial lymphocytes x HPF suggesting lymphocytic colitis, and 4 had both (≥40 MC and ≥20 intraepithelial lymphocytes x HPF). In the patients with high MC counts, figures were significantly higher in the right colon versus the left colon (p=0.016), but degranulation did not differ in the right versus the left colon (p=0.125). No age or sex-related difference was observed (p=0.527 and p=0.859 respectively). The prevalence of abdominal pain and bloating did not differ in the three groups (p=0.959 and p=0.140, respectively). Patients with lymphocytic colitis (p=0.008) and those with high MC counts (p=0.025) had significantly higher evacuation rates compared to controls. There was no difference between these two groups (p=0.831). Mast cell degranulation was not associated with the number of evacuations, abdominal pain, or bloating (p=0.51; p=0.41; p=0.42, respectively). The finding that a significantly higher number of evacuations was linked to increased MC in the colonic mucosa of a subset of patients with otherwise normal laboratory and endoscopic findings suggests that "mastocytic colitis" may be a new clinical-pathological entity responsible for chronic non-bloody diarrhea. Prospective studies with a larger number of patients, as well as endoscopic and histological follow-up, are needed to confirm this hypothesis.

show abstract

What is the incidence of celiac disease in patients with microscopic colitis? Why are these two diseases related?

Ebik¹,

Ekin²,

Bacaksız³

et al. 2024

View full text Add to dashboard Cite

Introduction Although there are studies in the literature showing that celiac disease (CD) is more common in patients with microscopic colitis (MC), there are publications to the contrary. The pathophysiologies of both diseases are different from each other. Aim To investigate the frequency of CD in MC patients, the different features of these 2 diseases, and the relationship between them. Material and methods In our prospective and cross-sectional analytical study, the presence of CD was investigated in 90 patients diagnosed with MC by colonoscopy and biopsy due to chronic diarrhoea between September 2011 and December 2021. Results We detected MC in 102 (9.3%) of 1096 patients investigated for chronic diarrhoea. We detected CD in 1 (1.1%) of 90 patients with MC who participated in the study. Only 10% of the patients were positive for AGA IgA, 3.3% for EMA IgA, and 2.2% for Anti-TG2 IgA. There was no difference in autoantibody titre in treatment-responsive and treatment-resistant MC patients. HLA DQ2 was positive in 32.2% ( n = 29) of the MC patients, and HLA DQ8 was found in 5.5% ( n = 5). Intraepithelial lymphocyte increase was remarkable in the duodenal biopsies of MC patients who did not respond to treatment (40% vs. 11.4%; p = 0.007). Conclusions We did not reach the conclusion that CD is more common in MC patients. An increase in IEL may also occur in the small intestine in patients with MC who do not respond to treatment.

show abstract

Medication Exposure and the Risk of Microscopic Colitis: Results from a Prospective us Trial

Cited by 3 publications

References 0 publications

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations

Is mastocytic colitis a specific clinical-pathological entity?

What is the incidence of celiac disease in patients with microscopic colitis? Why are these two diseases related?

Contact Info

Product

Resources

About