Microscopic colitis in Uppsala health region, a population-based prospective study 2005–2009

Thörn, Magnus; Sjöberg, Daniel; Ekbom, Anders; Holmström, Tommy; Larsson, Märit; Nielsen, Anne-Lie; Holmquist, Lars Erik; Thelander, Ulrika; Wanders, Alkwin; Rönnblom, Anders

doi:10.3109/00365521.2013.800993

Cited by 40 publications

(59 citation statements)

References 25 publications

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“…Population studies have shown an increasing incidence of MC over recent decades, with a mean incidence rate of 1.1-7.0/100,000 inhabitants for CC and an incidence rate of 3.1-5.5/100,000 inhabitants for LC [Fernandez-Banares et al 1999;Olesen et al 2004b;Pardi et al 2007;Vigren et al 2012;Thörn et al 2013]. The increased incidence has stabilized over the past years, and the incidence is associated with female gender and increasing age [Gentile et al 2014].…”

Section: Epidemiologymentioning

confidence: 93%

“…MC in this context should be considered as a part of the original IBD disease, and not as a separate entity [Jegadeesan et al 2013]. Furthermore, these changes can also be found in persons without any signs of gastrointestinal symptoms or diseases [Wang et al 1988;Thörn et al 2013]. Altogether, there is no histopathological hallmark that differentiates primary, idiopathic MC from a MC evolved secondary to another syndrome or its treatment, or that differentiate MC in healthy subjects from patients with symptoms.…”

Section: Histopathologymentioning

confidence: 99%

“…The diarrhea may be mild, but severe, frequent diarrhea with urgency is common [Bohr et al1996]. Nevertheless, some patients with histopathological features of MC are asymptomatic [Wang et al 1988;Gubbins et al 1991;Thörn et al 2013]. About 50% of patients with diagnosed MC fulfill the criteria for irritable bowel syndrome (IBS) .…”

Section: Clinical Presentationmentioning

confidence: 99%

“…The onset is often insidious, but 25-40% of the patients have a sudden onset [Bohr et al 1996;Olesen et al 2004a]. The majority of patients have only a single attack of the disease with spontaneous remission in about 10% [Gubbins et al 1991;Olesen et al 2004a;Roth et al 2013a;Thörn et al 2013], and the patients are in symptomatic remission after 3-4 years [Bonner et al 2000]. Thirty percent of patients with MC have a chronic intermittent disease, and only 7% have a chronic, continuous course which may be refractory to treatment [Järnerot et al 1995;Olesen et al 2004a].…”

Section: Clinical Presentationmentioning

confidence: 99%

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New insights and challenges in microscopic colitis

Ohlsson

2014

Therap Adv Gastroenterol

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Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with the intestinal lumen. Furthermore, some patients with a microscopic inflammation in their colonic mucosa have no symptoms, or are suffering from constipation or abdominal pain, rather than diarrhea. Recently, a discussion was initiated calling into question the overdiagnosing of symptoms and pointing out the danger of exacerbating people's perception of their ailments, of weakening their eligibility in health insurance, of overprescription of drugs, and thus the increasing cost to the society of health care. In the light of this discussion, this review will highlight histopathological and clinical features of MC, and discuss the diagnosis and management of this disease. Perhaps, the intestinal mucosa has no other mode by which to react than an inflammatory response, irrespective of the presence or absence of autoimmunity. Thus, to better identify and classify subgroups of MC, and to clarify and correctly handle the inflammatory changes, this field of research stands to benefit from a review of the results and experience gained to date.

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Section: Epidemiologymentioning

confidence: 93%

Section: Histopathologymentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

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New insights and challenges in microscopic colitis

Ohlsson

2014

Therap Adv Gastroenterol

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“…The largest retrospective cohort population study conducted to date did not report any association between MC and IBD [2]. What is more, one prospective population-based cohort study, conducted by Thörn et al [3], specifically aimed to address the potential bidirectional relationship between IBD and MC, including all new diagnoses of both IBD and MC during 2005-2009, also failed to document any significant correlation between the two conditions.…”

Section: Linkage Between Ibd and MCmentioning

confidence: 99%