Microscopic colitis

Burke, Kristin E.; D’Amato, Mauro; Ng, Siew C; Pardi, Darrell S.; Ludvigsson, Jonas F.; Khalili, Hamed

doi:10.1038/s41572-021-00273-2

Cited by 40 publications

(57 citation statements)

References 192 publications

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“…118 Medications (e.g. PPIs, histamine H2 receptor blockers, ticlopidine, flutamide, selective serotonin reuptake inhibitors, acarbose, NSAIDs, ICIs, statins, carbamazepine), 3,9,127 infection (e.g.…”

Section: What Are the Future Roles For The Pathologist In Assessment ...mentioning

confidence: 99%

Gut inflammation induced by drugs: Can pathology help to differentiate from inflammatory bowel disease?

Herlihy

Feakins

2022

UEG Journal

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Drug‐induced mucosal injury (DIMI) in the gastrointestinal tract is important to recognise, partly because cessation of the culprit agent alone may result in resolution of symptoms. An ever‐growing list of medications, including newer immunotherapeutic agents and targeted therapies, can cause gastrointestinal inflammation of varying severity. However, the diagnosis of DIMI is challenging, as a single drug can induce a variety of histopathological patterns of injury including acute colitis, chronic colitis, microscopic colitis, apoptotic colopathy, and ischaemic‐type colitis. An additional consideration is the potential clinical, endoscopic and histological overlap of DIMI with gastrointestinal mucosal injury secondary to other entities such as inflammatory bowel disease (IBD). We discuss DIMI of the gastrointestinal tract with an emphasis on histological patterns that mimic IBD, histological features which may distinguish the two entities, and the diagnostic role and limitations of the pathologist.

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Section: What Are the Future Roles For The Pathologist In Assessment ...mentioning

confidence: 99%

Gut inflammation induced by drugs: Can pathology help to differentiate from inflammatory bowel disease?

Herlihy

Feakins

2022

UEG Journal

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“…Studies characterizing specific microbial changes in MC have been small in sample size, and were, for the most part, cross-sectional and did not yield consistent findings [5][6][7][8][9][10]. These studies have recently been reviewed [3,11]. In all of them, faecal samples for microbiota studies were obtained after diagnostic colonoscopy, without considering the effect of colonic lavage on the results.…”

Section: Introductionmentioning

confidence: 99%

Colonic bacterial diversity and dysbiosis in active microscopic colitis as compared to chronic diarrhoea and healthy controls: effect of polyethylene glycol after bowel lavage for colonoscopy

et al. 2022

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Background Most microbiota studies in microscopic colitis patients are performed after diagnostic colonoscopy without considering the potential effect of colonic lavage. Patients may achieve clinical remission after colonoscopy and it is unknown whether lavage-induced changes play a role. Aim To assess the effect of polyethylene glycol (PEG) colonic lavage on clinical remission rate, microbial diversity, microbial dysbiosis index and specific microbial changes in patients with active microscopic colitis as compared to other diarrhoeal diseases and healthy controls. Methods Fifty-five consecutive patients presenting chronic watery diarrhoea and 12 healthy controls were included. Faecal samples were collected three days before and 30 days after PEG in patients and controls for microbiome analysis. Results Clinical remission was observed in 53% of microscopic colitis patients, and in 32% of non-microscopic colitis patients (p = 0.16). Considering patients with persisting diarrhoea after colonoscopy, 71% of non-microscopic colitis patients had bile acid diarrhoea. Baseline Shannon Index was lower in diarrhoea groups than in healthy controls (p = 0.0025); there were no differences between microscopic colitis, bile-acid diarrhoea and functional diarrhoea. The microbial dysbiosis index was significantly higher in microscopic colitis than in bile acid diarrhoea plus functional diarrhoea (p = 0.0095), but no bacterial species showed a significantly different relative abundance among the diarrheal groups. Conclusions Dysbiosis is a feature in active microscopic colitis, but loss of microbial diversity was similar in all diarrheal groups, suggesting that faecal microbial changes are not due to microscopic colitis itself but associated with stool form. A considerable number of microscopic colitis patients achieved clinical remission after colonoscopy, but we were unable to demonstrate related PEG-induced changes in faecal microbiome.

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“…Microscopic colitis (MC) is a chronic immune-inflammatory bowel disease, with a tendency to affect senior individuals (generally ⩾65 years of age), especially women. 1 – 3 MC was first described in the 1970s (first, collagenous colitis in 1976, 4 whereas the term ‘microscopic colitis’ was first mentioned in 1980). MC comprises two subtypes (lymphocytic and collagenous colitis, LC and CC, respectively), and a third incomplete (MCi) variant was described as well.…”

Section: Introductionmentioning

confidence: 99%

“… 6 – 9 It is suggested that the pathogenesis of MC is related to derailed immune responses to the gut microenvironment triggered by exogenous factors (pharmacologic and lifestyle) in the genetically susceptible. 3 , 10 There are certain overlaps in genetic risk with other immune-mediated disorders. 11 – 13…”

Section: Introductionmentioning

confidence: 99%

Microscopic colitis in older adults: impact, diagnosis, and management

Fedor

Zöld

Barta

2022

Therapeutic Advances in Chronic Disease

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Microscopic colitis (comprising lymphocytic and collagenous colitis, albeit an incomplete variant is gaining recognition as well) is a chronic, immune-mediated inflammatory state of the lower gastrointestinal tract (colon). The diagnosis requires diagnostic colonoscopy with characteristic histopathological findings. They have a propensity to present in senior populations (above 60 years of age), particularly women – who are approximately 2.5–3 times more likely to develop microscopic colitis. Preexisting other immune-inflammatory diseases are also shown to predispose patients for the development of microscopic colitis. The classic presentation is profuse watery diarrhea, often during the night or early morning hours. Fecal incontinence and abdominal pain are frequent as well. Thus, the disease impacts patients’ quality of life and well-being. The first described cases date back to the seventies and eighties of the twentieth century, thereby they can be considered fairly recently discovered disease states. Our understanding of the disease and its pathophysiology is still incomplete. Although there is a lack of unified recommendation for treatment, most clinicians prefer the use of budesonide, and most published guidelines regard this locally acting glucocorticoid as the therapy of choice. In our article, we aimed for a brief, noncomprehensive overview of the clinical significance, diagnosis, and management of microscopic colitis.

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Microscopic colitis

Cited by 40 publications

References 192 publications

Gut inflammation induced by drugs: Can pathology help to differentiate from inflammatory bowel disease?

Gut inflammation induced by drugs: Can pathology help to differentiate from inflammatory bowel disease?

Colonic bacterial diversity and dysbiosis in active microscopic colitis as compared to chronic diarrhoea and healthy controls: effect of polyethylene glycol after bowel lavage for colonoscopy

Microscopic colitis in older adults: impact, diagnosis, and management

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