Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 7, 2009; 15(25): 3122-3127
Published online Jul 7, 2009. doi: 10.3748/wjg.15.3122
Microscopic colitis: A large retrospective analysis from a health maintenance organization experience
Kevin T Kao, Benito A Pedraza, Amy C McClune, David A Rios, Yi-Qiong Mao, Robert H Zuch, Michael H Kanter, Sony Wirio, Chris N Conteas
Kevin T Kao, Benito A Pedraza, Amy C McClune, Chris N Conteas, Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California 90027, United States
David A Rios, Department of Internal Medicine, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California 90027, United States
Yi-Qiong Mao, Robert H Zuch, Michael H Kanter, Sony Wirio, Department of Pathology, Southern California Kaiser Permanente Medical Group, California 90027, United States
Author contributions: Kao KT, Pedraza BA, McClune AC, Rios DA and Conteas CN provided original study design, data collection, data analysis and manuscript correction and editing; Mao YQ, Zuch RH, Kanter MH and Wirio S provided vital review of pathology; Kao KT wrote the manuscript.
Correspondence to: Dr. Kevin T Kao, Department of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, 1526 N. Edgemont St. 7th floor Gastroenterology, Los Angeles, California 90027, United States. kevin.t.kao@kp.org
Telephone: +1-323-7835153
Fax: +1-323-7837056
Received: April 9, 2009
Revised: May 18, 2009
Accepted: May 25, 2009
Published online: July 7, 2009
Abstract

AIM: To examine the demographic data on a large multi-ethnic population of patients with microscopic colitis (MC) in Southern California and to determine the association of MC with inflammatory bowel disease (IBD) and colorectal cancer.

METHODS: All patients diagnosed with MC by colonic biopsy from 1996-2005 were identified utilizing a pathology database. All biopsies were reviewed by experienced pathologists utilizing standard histologic criteria. Patients’ medical records were reviewed and data regarding patient age, co-morbidities, sex, ethnicity, and medications were analyzed. An age- and sex-matched standard control group was also generated. Chi-square test was used to evaluate the associations of co-morbidities between lymphocytic colitis (LC), collagenous colitis (CC) and the control group.

RESULTS: A total of 547 cases of MC were identified, 376 patients with LC and 171 patients with CC. The female/male ratio was 3:1 in CC and 2.7:1 in LC patients. Celiac disease (P < 0.001), irritable bowel syndrome (IBS) (P < 0.001), and thyroid diseases (P < 0.001) were found to have a higher occurrence in MC compared to the control group. No statistical differences in the occurrence of colorectal cancer, diabetes and IBD were found between the MC group and the control group.

CONCLUSION: This is the largest group of patients with MC known to the authors that has been studied to date. Conditions such as celiac disease, IBS, and thyroid diseases were found to be related to MC. Furthermore, neither an increased risk of colorectal cancer nor IBD was associated with MC in this study.

Keywords: Collagenous colitis, Inflammatory bowel disease, Lymphocytic colitis, Microscopic colitis