Department of Medicine, Division of Gastroenterology
Digestive System Diseases | Gastroenterology | Immune System Diseases
Microscopic colitis is a common cause of chronic, nonbloody diarrhea. Microscopic colitis is more common in women than men and usually affects patients in their sixth and seventh decade. This article reviews the etiology and medical management of microscopic colitis. The etiology of microscopic colitis is unknown, but it is associated with autoimmune disorders, such as celiac disease, polyarthritis, and thyroid disorders. Smoking has been identified as a risk factor of microscopic colitis. Exposure to medications, such as non-steroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors, is suspected to play a role in microscopic colitis, although their direct causal relationship has not been proven. Multiple medications, including corticosteroids, anti-diarrheals, cholestyramine, bismuth, 5-aminosalicylates, and immunomodulators, have been used to treat microscopic colitis with variable response rates. Budesonide is effective in inducing and maintaining clinical remission but relapse rate is as high as 82% when budesonide is discontinued. There is limited data on management of steroid-dependent microscopic colitis or refractory microscopic colitis. Immunomodulators seem to have low response rate 0%-56% for patients with refractory microscopic colitis. Response rate 66%-100% was observed for use of anti-tumor necrosis factor (TNF) therapy for refractory microscopic colitis. Anti-TNF and diverting ileostomy may be an option in severe or refractory microscopic colitis.
Chronic diarrhea, Collagenous colitis, Etiology of microscopic colitis, Lymphocytic colitis, Microscopic colitis, Refractory microscopic colitis, Steroid-dependent microscopic colitis
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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
DOI of Published Version
World J Gastroenterol. 2015 Aug 7;21(29):8804-10. doi: 10.3748/wjg.v21.i29.8804. Link to article on publisher's site
World journal of gastroenterology
Park, Tina; Cave, David R.; and Marshall, Christopher, "Microscopic colitis: A review of etiology, treatment and refractory disease" (2015). Open Access Articles. 2624.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License