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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 28, 2008; 14(48): 7280-7288
Published online Dec 28, 2008. doi: 10.3748/wjg.14.7280
Diagnosis and management of microscopic colitis
Curt Tysk, Johan Bohr, Nils Nyhlin, Anna Wickbom, Sune Eriksson
Curt Tysk, Johan Bohr, Nils Nyhlin, Anna Wickbom, Department of Medicine, Division of Gastroenterology, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, SE-701 85 Örebro, Sweden
Sune Eriksson, Department of Pathology, Örebro University Hospital, SE-701 85 Örebro, Sweden
Author contributions: All authors contributed in writing the article.
Supported by Grants 16898-2005, 18293-2006 and 21142-2008 from the Swedish Society of Medicine (Bengt Ihre Foundation), Örebro County Research Committee, and Örebro University Hospital Research Foundation
Correspondence to: Curt Tysk, Professor, Department of Medicine, Division of Gastroenterology, Örebro University Hospital, SE-701 85 Örebro, Sweden. curt.tysk@orebroll.se
Telephone: +46-19-6021000 Fax: +46-19-6021774
Received: October 28, 2008
Revised: December 3, 2008
Accepted: December 10, 2008
Published online: December 28, 2008
Abstract

Microscopic colitis, comprising collagenous and lymphocytic colitis, is characterized clinically by chronic watery diarrhea, and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100 000 inhabitants, with a peak incidence in 60-70-year-old individuals and a noticeable female predominance for collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue and fecal incontinence are common symptoms, which impair the health-related quality of life of the patient. There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented short-term treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.

Keywords: Microscopic colitis; Collagenous colitis; Lymphocytic colitis; Chronic diarrhea; Budesonide