Microscopic Colitis

The colon, also known as the large intestine, is a long tube in your belly. It's responsible for moving waste through your body so it can leave your body. The rectum is the very last part of the colon.

Microscopic colitis is a condition where the lining of the colon gets swollen and irritated. This irritation, or inflammation, leads to symptoms like watery diarrhea.

The name "microscopic colitis" comes from the fact that doctors need to look closely at a sample of colon tissue under a microscope to diagnose it. A regular colonoscopy or a similar exam often looks normal, which is why a microscopic view is needed.

There are two main types of microscopic colitis:

• Collagenous colitis: In this type, a thick layer of a protein called collagen builds up in the colon's tissues.

• Lymphocytic colitis: In this type, there's a higher-than-normal number of white blood cells called lymphocytes in the colon's tissues.

Scientists think collagenous and lymphocytic colitis might be different ways the same underlying condition shows up. The symptoms, how it's diagnosed, and the ways it's treated are similar for both types.

Microscopic colitis is a condition causing digestive problems. Key symptoms include:

• Frequent watery bowel movements: This is a common and often noticeable symptom. The diarrhea might be severe, making it difficult to control.

• Belly pain, cramping, or bloating: These abdominal issues can range from mild discomfort to intense pain. The bloating can make your stomach feel full.

• Weight loss: If you're experiencing significant diarrhea, you might lose weight unintentionally due to the loss of nutrients and fluids.

• Nausea: This feeling of sickness in the stomach can accompany the other symptoms.

• Loss of bowel control (fecal incontinence): In some cases, microscopic colitis can make it hard to hold your bowel movements, leading to accidents.

• Dehydration: Frequent watery stools can lead to your body losing too much water, which can be serious. This is why it's important to drink plenty of fluids.

It's important to note that symptoms of microscopic colitis can sometimes disappear on their own, but they can also come and go. If you experience persistent watery diarrhea lasting more than a few days, it's crucial to see a doctor. Early diagnosis and treatment are essential to manage the condition effectively.

If you have diarrhea that's loose and watery, and it lasts for more than a few days, it's important to see a doctor. They can figure out what's causing it and give you the best treatment plan.

Microscopic colitis is a condition where the lining of the colon becomes swollen and irritated. Doctors don't fully understand what causes this inflammation. However, several factors are suspected:

• Certain medications: Some medicines can irritate the colon's lining, leading to swelling. This is important to discuss with your doctor. If you have microscopic colitis and are taking medication, it's essential to talk to your doctor about potential links.

• Bile acid issues: Bile acid is a substance produced by the liver that helps digest food. Sometimes, the body doesn't absorb bile acid properly. This excess bile acid can irritate the colon's lining, causing inflammation.

• Infectious agents: Certain bacteria or viruses can produce toxins that harm the colon's lining. These infections can trigger inflammation.

• Autoimmune problems: Some people with microscopic colitis also have other autoimmune diseases. Autoimmune diseases happen when the body's immune system mistakenly attacks its own healthy tissues. Examples include rheumatoid arthritis, celiac disease, and psoriasis. If you have a known autoimmune condition, it's important to be aware of the potential link to microscopic colitis.

Microscopic colitis is a condition affecting the lining of the intestines. Several things can increase your chances of getting it.

Factors that may increase your risk:

• Age: Most people diagnosed with microscopic colitis are over 50. This means that while it can occur at any age, the risk is higher as you get older.
• Gender: Women are more likely to develop microscopic colitis than men. Some research suggests a connection between hormone replacement therapy after menopause and a higher risk. Further study is needed to understand this link better.
• Other health conditions: People with microscopic colitis often have other autoimmune conditions like celiac disease, thyroid problems, rheumatoid arthritis, type 1 diabetes, or psoriasis. Having one of these conditions might make you more vulnerable to microscopic colitis.
• Family history: If someone in your family has irritable bowel syndrome (IBS), you might have a slightly increased risk of developing microscopic colitis. This doesn't mean you will definitely get it, but it's a factor to be aware of.
• Smoking: Studies show a connection between smoking and microscopic colitis, particularly among people aged 16 to 44. This suggests that smoking may increase the risk of this condition in this age group.

Certain medications might be linked to microscopic colitis:

Some medicines have been linked to microscopic colitis, but the research isn't always consistent. This means some studies show a connection, but other studies don't.

• Pain relievers: Medications like aspirin, ibuprofen, and naproxen sodium are examples of pain relievers that might potentially increase the risk.
• Acid-reducing medications: Proton pump inhibitors (PPIs), used to reduce stomach acid, are another group of drugs that have been linked to the condition. These include lansoprazole, esomeprazole, pantoprazole, rabeprazole, omeprazole, and dexlansoprazole.
• Other medications: Many other medicines have also been associated with microscopic colitis. These include selective serotonin reuptake inhibitors (SSRIs) like sertraline, acarbose, flutamide, ranitidine, carbamazepine, clozapine, entacapone, paroxetine, simvastatin, and topiramate.

Important Note: If you are taking any of these medications and are concerned about your risk of microscopic colitis, discuss this with your doctor. They can help you weigh the potential benefits of the medication against the possible risks. This information is not a substitute for professional medical advice. Always consult with a healthcare provider for any health concerns.

Microscopic colitis usually doesn't cause serious problems after treatment. People who have this condition don't have a higher chance of getting colon cancer. In other words, once the condition is managed, most people can expect a normal life without extra health concerns related to colon cancer.

Diagnosing Microscopic Colitis: Tests and Procedures

Microscopic colitis is a condition causing diarrhea. To figure out if this is the cause, or if something else is causing your symptoms, your doctor will likely do a few things:

Medical History and Physical Exam: First, your doctor will ask about your overall health, including any other conditions you might have, like celiac disease. They'll also ask about any medications you're taking. A physical exam will help them check for other possible causes.

Tests to Check the Colon: To look inside your colon and identify microscopic colitis, your doctor might use a few different procedures:

• Colonoscopy: During a colonoscopy, a long, thin, flexible tube with a camera (called a colonoscope) is inserted into your rectum. The camera sends pictures of your entire colon to a monitor, allowing your doctor to see the lining. The doctor can also use tools through the tube to take a small tissue sample (biopsy) to examine under a microscope.

• Flexible Sigmoidoscopy: A sigmoidoscopy is similar to a colonoscopy, but it only examines the lower part of your colon (the sigmoid colon) and rectum. This is the last 1-2 feet of your large intestine. A thin, flexible tube with a camera (called a sigmoidoscope) is inserted to view the lining. A biopsy can also be taken.

Confirming Microscopic Colitis:

To confirm a diagnosis of microscopic colitis, biopsies are crucial. The tissues in microscopic colitis often look normal, so your doctor needs to look closely at samples under a microscope. These biopsies are taken during either a colonoscopy or a flexible sigmoidoscopy.

Other Tests to Rule Out Other Causes:

In addition to colon exams, your doctor might order other tests to rule out other potential causes of your diarrhea:

• Stool Sample: A stool sample can help determine if an infection is the cause.

• Blood Test: A blood test can check for signs of anemia or celiac disease.

• Upper Endoscopy with Biopsy: An upper endoscopy examines the upper part of your digestive tract, looking for problems like celiac disease. A tissue sample (biopsy) is taken if needed for further examination.

These tests, and your doctor's overall assessment, help determine if microscopic colitis is the cause of your symptoms or if another condition is responsible.

Microscopic colitis can sometimes improve on its own, but if symptoms are severe or persistent, treatment might be necessary. Doctors typically start with the simplest treatments that are least likely to cause side effects.

Lifestyle Changes:

Often, the first step involves adjusting your diet and potentially stopping certain medications. A low-fat, low-fiber diet can sometimes help reduce diarrhea in the short-term, but isn't a long-term solution for microscopic colitis. This diet might also involve limiting dairy, gluten, caffeine, and sugar, as these can worsen symptoms. If a medication you're taking is contributing to the problem, switching to a different one might be helpful.

Medications:

If lifestyle changes aren't enough, your doctor might suggest other medications:

• Anti-diarrheal medications: These include loperamide (like Imodium) or bismuth subsalicylate (like Pepto-Bismol), which can help reduce diarrhea.
• Steroids: Certain steroids, such as budesonide, are often used to reduce inflammation in the colon.
• Bile acid-binding resins: These medicines, like cholestyramine or colestipol, can help manage diarrhea by reducing the amount of bile acids in your digestive system.
• Immunosuppressants: For some, medications that suppress the immune system, such as mercaptopurine or azathioprine, are used to lessen inflammation.
• Biologics: Biologic medications like infliximab, adalimumab, or vedolizumab can also reduce inflammation in the colon.

Surgery:

In rare cases where symptoms are severe and other treatments don't work, surgery to remove part or all of the colon might be considered.

Important Note: This information is for general knowledge and does not constitute medical advice. Always consult with a healthcare professional for diagnosis and treatment of any health condition. They can properly assess your specific situation and recommend the most appropriate course of action.