Materiały źródłowe

• #1 Microscopic colitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/microscopic-colitis/symptoms-causes/syc-20351478

  The condition gets its name from needing to look at colon tissue under a microscope to diagnose it. […] If you have watery diarrhea that lasts more than a few days, contact your healthcare professional to diagnose and treat your condition.

• #2 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  Microscopic colitis is an inflammatory bowel disease divided into two subtypes: collagenous colitis and lymphocytic colitis. […] Therefore, physicians should be familiar with its clinical features and management strategies because the disease deserves the same attention as the classical inflammatory bowel diseases. […] Here, state-of-the-art knowledge of microscopic colitis is provided from a global perspective with reference to etiopathology and how to establish the diagnosis with the overall aim to create awareness and improve rational management in clinical practice. […] As biomarkers are absent, the diagnosis relies on colonoscopy with a histological assessment of biopsy specimens from all parts of the colon. […] The diagnosis of microscopic colitis is based on a full colonoscopy with histopathological assessment of multiple random biopsies obtained from the entire colon despite endoscopic absence of any macroscopic abnormalities.

• #3 Microscopic colitis: Etiopathology, diagnosis, and rational management | eLife

  https://elifesciences.org/articles/79397

  Microscopic colitis is an inflammatory bowel disease divided into two subtypes: collagenous colitis and lymphocytic colitis. […] Therefore, physicians should be familiar with its clinical features and management strategies because the disease deserves the same attention as the classical inflammatory bowel diseases. […] Here, state-of-the-art knowledge of microscopic colitis is provided from a global perspective with reference to etiopathology and how to establish the diagnosis with the overall aim to create awareness and improve rational management in clinical practice. […] As biomarkers are absent, the diagnosis relies on colonoscopy with a histological assessment of biopsy specimens from all parts of the colon. […] The diagnosis of microscopic colitis is based on a full colonoscopy with histopathological assessment of multiple random biopsies obtained from the entire colon despite endoscopic absence of any macroscopic abnormalities.

• #4 Diagnosis of Microscopic Colitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis/diagnosis

  To help diagnose microscopic colitis, your doctor will ask about your symptoms and medical history and will perform a physical exam. […] Your doctor may order medical tests, such as blood and stool tests, to check for signs of conditions that cause symptoms similar to those of microscopic colitis. […] Doctors order a colonoscopy with biopsies to diagnose microscopic colitis and rule out other digestive conditions. […] To diagnose microscopic colitis, a pathologist will examine the tissue under a microscope to check for signs of the disease.

• #5 Microscopic Colitis

  https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/understanding-crohns-and-colitis/microscopic-colitis

  The main symptom of Microscopic Colitis is ongoing watery diarrhoea. Other symptoms include bloating, wind and tummy pain. […] It can be difficult to diagnose Microscopic Colitis because it has similar symptoms to other conditions, like irritable bowel syndrome and coeliac disease. […] Healthcare professionals may only be able to diagnose Microscopic Colitis by looking at a tissue sample from your colon under a microscope. […] Talk to your GP if you think your symptoms could be caused by Microscopic Colitis. Your GP will need to take a history of all your symptoms. This may help them rule out other conditions. […] If your GP thinks you may have Microscopic Colitis, you will need to be referred for a colonoscopy and a biopsy. […] In Microscopic Colitis, signs of inflammation can only be seen under a microscope. You will need to have a colonoscopy so that a tissue sample, or biopsy, can be taken.

• #6 Microscopic colitis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/3000315

  Key diagnostic factors include the presence of risk factors and chronic watery, nonbloody diarrhea. […] Other diagnostic factors include fecal urgency, fecal incontinence, nocturnal stools, abdominal pain, weight loss, bloating, and fatigue. […] 1st tests to order include CBC, basic metabolic panel, CRP, erythrocyte sedimentation rate, immunoglobulin A-tissue transglutaminase, stool studies for infective pathogens, stool O+P, lateral flow immunoassay (Giardia), ileocolonoscopy, and colonic biopsies.

• #7 Microscopic Colitis: Treatment, Symptoms & What It Is

  https://my.clevelandclinic.org/health/diseases/17227-microscopic-colitis

  Microscopic colitis is usually diagnosed by a gastroenterologist, a specialist in gastrointestinal diseases. Theyll begin by asking you about your medical history and your current medications. They may order various lab tests to check for possible causes of your condition, including blood tests, stool tests and imaging tests. If these dont turn up anything, your doctor will proceed with a colonoscopy and biopsy. […] During the colonoscopy, your doctor will view the inside of your colon through a long, flexible instrument called a colonoscope. The colonoscope will be inserted into your colon through your rectum while you are sedated. Your doctor can pass tools through the colonoscope to take a tissue sample from your intestinal lining to examine under the microscope. This is how theyll find microscopic colitis.

• #8 SciELO Brazil – DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROL

  https://www.scielo.br/j/ag/a/tPZKRdCPbYCzSSxdgHZfwKL/

  The endoscopic appearance of the colon is usually normal or nearly normal, and diagnosis relies on histologic finding. […] Colonoscopy is required for the investigation of microscopic colitis. During the examination, the endoscopist should be advised to take biopsies from the right and left colon, even if there are no endoscopic findings. […] The two major histological subtypes of MC are CC and LC, but incomplete forms may occur MCi. […] The histopathologic criteria of CC is the presence of a thickened subepithelial collagenous band 10 m, permeated by capillaries and some inflammatory cells, combined with an increased inflammatory infiltrate in the lamina propria dominated by plasma cells and lymphocytes, but might also include eosinophils, mast cells and, more rarely, neutrophils. […] The primary step in managing patients with MC is to assess for factors that may worsen diarrhea, such as certain dietary elements (lactose, artificial sweeteners) and medications associated with diarrhea or trigger MC.

• #9 Diagnosis of Microscopic Colitis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/microscopic-colitis/diagnosis.html

  The best way to diagnose your condition is by examining a tissue sample (biopsy) of your colon under a microscope. […] The IBD team at Stanford Health Care works seamlessly with doctors who specialize in interpreting colon biopsies (clinical pathologists) to offer a precise diagnosis for your condition. […] As part of our comprehensive approach to care, we also try to rule out other conditions that cause diarrhea, such as viruses and food intolerances. […] To do this, you may need one or more of the following tests, including: […] Colonoscopy or sigmoidoscopy: Examining the entire length of your colon (colonoscopy) or just the lower part of your colon (sigmoidoscopy) with the help of a small flexible tube and tiny camera we insert into your rectum (endoscope). […] Stool culture: Also known as a fecal occult blood test (FOBT), this test can identify microscopic amounts of blood, white blood cells and evidence of food intolerances.

• #10 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies and Procedures

  https://emedicine.medscape.com/article/180664-workup

  A thorough history and physical examation with routine blood work including complete blood cell count, metabolic profile, thyroid profile, stool studies, and celiac serologies are indicated in patients with suspected microscopic colitis (MC). […] United European Gastroenterology (UEG) and the European Microscopic Colitis Group (EMCG) recommendations include the following: Ileocolonoscopy, with biopsies from at least the right and left colon. […] Biopsies obtained by sigmoidoscopy or colonoscopy are necessary to diagnose lymphocytic colitis (LC) or collagenous colitis (CC). […] Approximately 95% of patients with microscopic colitis will have diagnostic left colon biopsies; but, if these biopsies are nondiagnostic at sigmoidoscopy in a patient in whom clinical suspicion remains high, total colonoscopy for right-sided biopsies may confirm the diagnosis.

• #11 A Functional Medicine Microscopic Colitis Protocol: Testing, Therapeutic Diets, and Supplements

  https://www.rupahealth.com/post/a-functional-medicine-microscopic-colitis-protocol-testing-therapeutic-diets-and-supplements

  Microscopic colitis is a chronic inflammatory bowel condition that can significantly affect the quality of life. […] Physicians should be familiar with the nuances of microscopic colitis and management strategies to appropriately address this underrecognized condition. […] Endoscopic evaluation of the colon with mucosal biopsies is required for diagnosing microscopic colitis and distinguishing between its two subtypes. […] A complete blood count (CBC) should be ordered to screen for infection and rule out anemia, which occurs in half of the patients with microscopic colitis. […] Celiac disease should be on the differential diagnosis for patients with chronic diarrhea and other gastrointestinal symptoms. […] Half of patients with microscopic colitis have an elevated erythrocyte sedimentation rate (ESR), a non-specific inflammatory marker.

• #12

  https://www.asge.org/home/resources/key-resources/blog/view/practical-solutions/2023/09/27/case-9–microscopic-colitis

  Microscopic colitis is a chronic disease of the colon, characterized by chronic, watery, non-bloody diarrhea. Microscopic colitis is subdivided into collagenous colitis and lymphocytic colitis. […] Evaluation of microscopic colitis includes CBC, CMP and stool cultures, including C difficile and celiac serology. Consider testing for ova and parasites if the patient has risk factors. […] Most experts recommend performing a colonoscopy with a biopsy of the right and left sides of the colon to reduce the potential for false-negative biopsy results, as microscopic colitis can be patchy in location. However, flexible sigmoidoscopy will diagnose 90 percent of microscopic colitis. […] Relapse occurs in up to 80 percent of patients after tapering off initial therapy. Patients can be maintained on the lowest effective dose of budesonide chronically if needed.

• #13 Diagnosis and management of microscopic colitis: current perspectives | CEG

  https://www.dovepress.com/diagnosis-and-management-of-microscopic-colitis-current-perspectives-peer-reviewed-fulltext-article-CEG

  Microscopic colitis (MC), a mutual term for a group of inflammatory disorders of the colon described and evolving during the past few decades, has emerged as a common cause of chronic nonbloody diarrhea. […] As the name indicates, the condition can be diagnosed only by microscopic assessment of colonic mucosal biopsies. […] The diagnosis of MC relies only on findings of characteristic histopathologic features in colonic mucosal biopsies. […] Routine laboratory tests are nondiagnostic, and only nonspecific abnormalities may be found, such as moderately increased levels of C-reactive protein, erythrocyte-sedimentation rate, or mild anemia. […] The diagnostic accuracy of fecal calprotectin and lactoferrin is low in MC in contrast to ulcerative colitis and Crohns disease. […] Therefore, there has been a search for alternative biomarkers reflecting mucosal inflammation.

• #14 Getting a diagnosis for Crohn’s Disease, Ulcerative Colitis or Microscopic Colitis

  https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/understanding-crohns-and-colitis/how-to-get-a-diagnosis

  A faecal calprotectin test may not be helpful for diagnosing Microscopic Colitis. For this condition, faecal calprotectin levels are often quite low. […] During an endoscopy, small samples of tissue are often taken from the gut, known as biopsies. These samples can be looked at under a microscope to help understand what’s causing your symptoms. These tissues samples are essential for diagnosing Microscopic Colitis. In Microscopic Colitis, an endoscopy may not show any visible signs of inflammation. Instead, changes in the gut can only be seen under a microscope. Microscopic Colitis is a type of Inflammatory Bowel Disease that’s different from Crohn’s or Ulcerative Colitis. […] If you have Microscopic Colitis, then your colon and rectum may look normal on a colonoscopy. During a colonoscopy, a tissue sample, known as a biopsy, may be taken from your gut. This biopsy will be looked at under a microscope for signs of Microscopic Colitis, which is the only way to diagnose it.

• #15 Microscopic colitis – IBD Clinic

  https://ibdclinic.ca/what-is-ibd/microscopic-colitis/

  Microscopic Colitis is diagnosed using a microscope to examine biopsies (tissue samples) taken from the lining of the colon during a colonoscopy. In a colonoscopy, a long flexible tube (about the thickness of your little finger) with a bright light and camera at its tip is inserted through the anus, allowing the specialist to examine the lining of the colon. During the investigation, the specialist will painlessly remove small pieces of tissue from the lining of the colon, to examine in the laboratory under a microscope. […] Your specialist may also do blood tests to rule out celiac disease (an allergy to gluten). Studies show that people with Microscopic Colitis are 50 times more likely to have celiac disease than the general population. For further information about these tests, see our information section IBD diagnostics.

• #16 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Differential Diagnoses

  https://emedicine.medscape.com/article/180664-differential

  Rule out microscopic colitis (MC) in those who fulfill the criteria for functional bowel disease, especially in the presence of risk factors for microscopic colitis and/or in the absence of response to therapy for irritable bowel syndrome (IBS). […] Microscopic colitis should be considered as a differential diagnosis in the workup of chronic diarrhea, especially in the elderly population. In addition, microscopic colitis should be considered in patients diagnosed with celiac disease who have diarrhea that fails to respond to a gluten-free diet. […] Patients whose condition fails to respond to reasonable medical therapy should be evaluated for other conditions that may clinically mimic lymphocytic colitis and collagenous colitis. […] Performing a colonoscopy on patients with chronic diarrhea is commonly accepted and widely practiced, but performing biopsies in all such individuals has a low yield, even with normal findings on endoscopy.

• #17 Microscopic colitis: What is it, and what are the treatment options? | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/4/215

  Microscopic colitis, an inflammatory disorder characterized by chronic diarrhea, is so named because its diagnosis requires histologic evaluation with mucosal biopsy. […] The diagnosis of microscopic colitis can be confirmed with colonoscopy with biopsy of the ascending and descending colon. […] Despite the inflammatory nature of microscopic colitis, there is little benefit to obtaining C-reactive protein and erythrocyte sedimentation rate values, as neither is elevated in most cases of microscopic colitis. […] The American Gastroenterological Association Institute guideline recommends mesalamine as a potential alternative to budesonide, but the European guidelines do not.

• #18 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  Microscopic colitis is an inflammatory bowel disease divided into two subtypes: collagenous colitis and lymphocytic colitis. […] Therefore, physicians should be familiar with its clinical features and management strategies because the disease deserves the same attention as the classical inflammatory bowel diseases. […] Here, state-of-the-art knowledge of microscopic colitis is provided from a global perspective with reference to etiopathology and how to establish the diagnosis with the overall aim to create awareness and improve rational management in clinical practice. […] As biomarkers are absent, the diagnosis relies on colonoscopy with a histological assessment of biopsy specimens from all parts of the colon. […] The diagnosis of microscopic colitis is based on a full colonoscopy with histopathological assessment of multiple random biopsies obtained from the entire colon despite endoscopic absence of any macroscopic abnormalities.

• #19 Microscopic colitis: Common cause of unexplained nonbloody diarrhea

  https://www.wjgnet.com/2150-5330/full/v5/i1/48.htm

  Microscopic colitis (MC) is characterized by chronic, watery, secretory diarrhea, with a normal or near normal gross appearance of the colonic mucosa. Biopsy is diagnostic and usually reveals either lymphocytic colitis or collagenous colitis. […] Histological workup can confirm a diagnosis of MC and distinguish the two distinct histological forms, namely, collagenous and lymphocytic colitis. […] The diagnosis of MC is dependent on (1) a convincing clinical history with other etiologies ruled out; (2) normal or near normal endoscopic and/or radiographic findings; and (3) endoscopic biopsies with histopathological findings consistent with MC. […] Endoscopy with biopsy is necessary to arrive at the diagnosis. Colonoscopy generally reveals normal mucosal appearance. However, non-specific changes such as erythema, edema, abnormal vascular markings or even tears associated with perforation have been described. The hallmark of microscopic colitis is an increase in inflammatory cells (i.e., lymphocytes) in colonic biopsies with an otherwise normal appearance and architecture of the colon. […] In lymphocytic colitis, these are the only abnormal features. […] In collagenous colitis, the features of lymphocytic colitis are present, with the additional presence of a characteristic thickened sub epithelial collagen band which may be up to 30 m thick.

• #20 Diagnosis and management of microscopic colitis

  https://www.wjgnet.com/1007-9327/full/v14/i48/7280.htm

  Barium enema and colonoscopy are usually normal, although subtle mucosal changes can be seen such as edema, erythema and abnormal vascular pattern. […] The long-term prognosis of MC is generally good. In a follow-up study of CC, 63% of the patients had a lasting remission after 3.5 years, and in another cohort study, all 25 patients were improved 47 mo after diagnosis, and only 29% of them required ongoing medication. […] The correct diagnosis depends on the awareness of the condition by the clinician (referring the patient with chronic diarrhea to colonoscopy and not to barium enema), by the endoscopist (obtaining mucosal biopsies although the colonic mucosa is endoscopically normal) and by the pathologist (recognizing the histopathological features of MC).

• #21

  https://link.springer.com/article/10.1007/s40266-023-01094-6

  Microscopic colitis, a diagnosis under the umbrella term of inflammatory bowel disease, is a prevalent cause of watery diarrhea, often with symptoms of urgency and bloating, typically observed in older adults aged 60 years. […] Although nonpathognomonic endoscopic abnormalities, including changes of the vascular mucosal pattern; mucosal erythema; edema; nodularity; or mucosal defects, e.g., cat scratches have been reported, a colonoscopy is typically macroscopically normal. […] As reliable biomarkers are unavailable, colonoscopy using random biopsies from various parts of the colon is compulsory. […] Based on the histological examination under a microscope, the disease is divided into collagenous (with a thickened subepithelial collagenous band) and lymphocytic (with intraepithelial lymphocytosis) colitis, although incomplete forms exist.

• #22 SciELO Brazil – DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROL

  https://www.scielo.br/j/ag/a/tPZKRdCPbYCzSSxdgHZfwKL/

  The endoscopic appearance of the colon is usually normal or nearly normal, and diagnosis relies on histologic finding. […] Colonoscopy is required for the investigation of microscopic colitis. During the examination, the endoscopist should be advised to take biopsies from the right and left colon, even if there are no endoscopic findings. […] The two major histological subtypes of MC are CC and LC, but incomplete forms may occur MCi. […] The histopathologic criteria of CC is the presence of a thickened subepithelial collagenous band 10 m, permeated by capillaries and some inflammatory cells, combined with an increased inflammatory infiltrate in the lamina propria dominated by plasma cells and lymphocytes, but might also include eosinophils, mast cells and, more rarely, neutrophils. […] The primary step in managing patients with MC is to assess for factors that may worsen diarrhea, such as certain dietary elements (lactose, artificial sweeteners) and medications associated with diarrhea or trigger MC.

• #23 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The minimal required histopathological criteria for the subtypes of microscopic colitis seem to be achieved in 90% of the left-sided biopsies (rectum excluded), demonstrating a pancolitis in most patients with microscopic colitis. […] In this context, it has been revealed that a flexible sigmoidoscopy is often inadequate and may miss the diagnosis in 20% of all patients if biopsies are not obtained above the rectosigmoid colon.

• #24 Microscopic colitis: Etiopathology, diagnosis, and rational management | eLife

  https://elifesciences.org/articles/79397

  Microscopic colitis is an inflammatory bowel disease divided into two subtypes: collagenous colitis and lymphocytic colitis. […] Therefore, physicians should be familiar with its clinical features and management strategies because the disease deserves the same attention as the classical inflammatory bowel diseases. […] Here, state-of-the-art knowledge of microscopic colitis is provided from a global perspective with reference to etiopathology and how to establish the diagnosis with the overall aim to create awareness and improve rational management in clinical practice. […] As biomarkers are absent, the diagnosis relies on colonoscopy with a histological assessment of biopsy specimens from all parts of the colon. […] The diagnosis of microscopic colitis is based on a full colonoscopy with histopathological assessment of multiple random biopsies obtained from the entire colon despite endoscopic absence of any macroscopic abnormalities.

• #25 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The minimal required histopathological criteria for the subtypes of microscopic colitis seem to be achieved in 90% of the left-sided biopsies (rectum excluded), demonstrating a pancolitis in most patients with microscopic colitis. […] In this context, it has been revealed that a flexible sigmoidoscopy is often inadequate and may miss the diagnosis in 20% of all patients if biopsies are not obtained above the rectosigmoid colon.

• #26 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The minimal required histopathological criteria for the subtypes of microscopic colitis seem to be achieved in 90% of the left-sided biopsies (rectum excluded), demonstrating a pancolitis in most patients with microscopic colitis. […] In this context, it has been revealed that a flexible sigmoidoscopy is often inadequate and may miss the diagnosis in 20% of all patients if biopsies are not obtained above the rectosigmoid colon.

• #27 Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl17061

  There is controversy regarding where and how many biopsies to obtain at time of colonoscopy. According to the American Society for Gastrointestinal Endoscopy (ASGE), it is suggested that two or more biopsies are obtained from the right, transverse, descending, and sigmoid colon if colonoscopy is done or two or more biopsies are taken from the transverse colon, sigmoid colon, and descending colon if flexible sigmoidoscopy is done (ASGE 2013). […] The diagnostic yield of colonoscopy in patients with chronic diarrhea ranges from 7% to 32%.49 It is the combination of clinical symptoms with histologic changes that yields a diagnosis of MC. […] LC is defined by the presence of intraepithelial lymphocytes (20/100 colonic surface epithelial cells), normal colonic architecture, lamina propria diffuse inflammation, and surface epithelial damage.

• #28 Two From the Ascending Colon and Two From the Descending Colon: Biopsies From Microscopic Colitis Simplified – Endoscopy Campus

  https://www.endoscopy-campus.com/en/ec-news/two-from-the-ascending-colon-and-two-from-the-descending-colon-biopsies-from-microscopic-colitis-simplified/

  Guidelines recommend that clinicians perform 8 biopsies total from the right and left sides of the colon to diagnose microscopic colitis (MC) in patients with recurrent watery diarrhea. […] In a study of 101 consecutive patients with microscopic colitis (collagenous colitis, n=52; lymphocytic colitis, n=42; and both, n=7), the diagnostic sensitivity of biopsy samples from specified sites were highest for MC in the ascending colon (97%), transverse colon (96%), and sigmoid colon (91%). […] COMMENT These data indicate that a simplified biopsy program of two specimens from the ascending colon and two from the descending colon could have 100% sensitivity for microscopic colitis. This is helpful as it could simplify the biopsy protocol and speed it up a bit in patients with suspected microscopic colitis.

• #29 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The minimal required histopathological criteria for the subtypes of microscopic colitis seem to be achieved in 90% of the left-sided biopsies (rectum excluded), demonstrating a pancolitis in most patients with microscopic colitis. […] In this context, it has been revealed that a flexible sigmoidoscopy is often inadequate and may miss the diagnosis in 20% of all patients if biopsies are not obtained above the rectosigmoid colon.

• #30 Microscopic Colitis: Pathogenesis and Diagnosis

  https://www.mdpi.com/2077-0383/12/13/4442

  Microscopic colitis is a type of inflammatory bowel disease and is classified as either collagenous colitis or lymphocytic colitis. The typical presentation is chronic watery diarrhea. […] The diagnosis of microscopic colitis depends on histological tissue obtained during colonoscopy. […] Current literature suggests that the histological findings may be patchy and not continuous throughout the colon and that it is the most severe in the proximal part of the colon. […] The European guideline strongly recommends that ileocolonoscopy should be performed in patients with suspected microscopic colitis and that biopsies should be taken from the right and the left side of the colon. […] The tissue obtained only from flexible sigmoidoscopy had low sensitivity and specificity. […] The current diagnostic guideline relies on histological tissue obtained from colonoscopy. However, many studies have proposed laboratory markers and fecal biomarkers to help with the diagnosis of microscopic colitis. […] The pathogenesis of microscopic colitis remains unknown and is likely complex and multifactorial. […] The management of microscopic colitis should be based on each individual’s underlying pathogenesis and involves budesonide, bile acid sequestrants, or immunosuppressive drugs in refractory cases.

• #31 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The minimal required histopathological criteria for the subtypes of microscopic colitis seem to be achieved in 90% of the left-sided biopsies (rectum excluded), demonstrating a pancolitis in most patients with microscopic colitis. […] In this context, it has been revealed that a flexible sigmoidoscopy is often inadequate and may miss the diagnosis in 20% of all patients if biopsies are not obtained above the rectosigmoid colon.

• #32 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  The pathognomonic finding on biopsies in lymphocytic colitis is an intraepithelial lymphocytosis, defined as 20 or more intraepithelial lymphocytes (IEL) per 100 surface epithelial cells with a mixed infiltrate of acute and chronic inflammatory cells present in the lamina propria and a normal collagenous band (5 M), typically without crypt distortion. […] However, mixed cases exist where histological changes of collagenous colitis are observed in some colonic segments, whereas other segments show changes of lymphocytic colitis. […] Therefore, it is uncertain whether the two histological forms are really different entities or whether they could be different stages of a single pathological process, a phase of the process, or an individual response to different triggers.

• #33 SciELO Brazil – DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROL

  https://www.scielo.br/j/ag/a/tPZKRdCPbYCzSSxdgHZfwKL/

  The endoscopic appearance of the colon is usually normal or nearly normal, and diagnosis relies on histologic finding. […] Colonoscopy is required for the investigation of microscopic colitis. During the examination, the endoscopist should be advised to take biopsies from the right and left colon, even if there are no endoscopic findings. […] The two major histological subtypes of MC are CC and LC, but incomplete forms may occur MCi. […] The histopathologic criteria of CC is the presence of a thickened subepithelial collagenous band 10 m, permeated by capillaries and some inflammatory cells, combined with an increased inflammatory infiltrate in the lamina propria dominated by plasma cells and lymphocytes, but might also include eosinophils, mast cells and, more rarely, neutrophils. […] The primary step in managing patients with MC is to assess for factors that may worsen diarrhea, such as certain dietary elements (lactose, artificial sweeteners) and medications associated with diarrhea or trigger MC.

• #34 Diagnosis and management of microscopic colitis: current perspectives | CEG

  https://www.dovepress.com/diagnosis-and-management-of-microscopic-colitis-current-perspectives-peer-reviewed-fulltext-article-CEG

  The histopathologic criteria of MC have been reviewed recently. […] The characteristic histopathologic features of CC are a subepithelial collagen band 10 m in thickness in comparison with a normal basal membrane of 3 m. […] The diagnosis of LC relies on an increased number of IELs. […] The exact cutoff level has not been determined, but 20 IELs per 100 epithelial cells is generally considered diagnostic for LC. […] A sigmoidoscopy with biopsy is thus not sufficient for diagnosing CC, and a pancolonoscopy with biopsies from the whole colon is required and will also rule out other colonic pathology.

• #35 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  The pathognomonic finding on biopsies in lymphocytic colitis is an intraepithelial lymphocytosis, defined as 20 or more intraepithelial lymphocytes (IEL) per 100 surface epithelial cells with a mixed infiltrate of acute and chronic inflammatory cells present in the lamina propria and a normal collagenous band (5 M), typically without crypt distortion. […] However, mixed cases exist where histological changes of collagenous colitis are observed in some colonic segments, whereas other segments show changes of lymphocytic colitis. […] Therefore, it is uncertain whether the two histological forms are really different entities or whether they could be different stages of a single pathological process, a phase of the process, or an individual response to different triggers.

• #36 Microscopic colitis: Etiopathology, diagnosis, and rational management | eLife

  https://elifesciences.org/articles/79397

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The pathognomonic finding on biopsies in lymphocytic colitis is an intraepithelial lymphocytosis, defined as 20 or more intraepithelial lymphocytes (IEL) per 100 surface epithelial cells with a mixed infiltrate of acute and chronic inflammatory cells present in the lamina propria and a normal collagenous band (5 M), typically without crypt distortion.

• #37 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies and Procedures

  https://emedicine.medscape.com/article/180664-workup

  Collagenous colitis (CC) demonstrates a thick colonic subepithelial collagenous deposit (10 m) and an increased inflammatory infiltrate in the lamina propria, whereas lymphocytic colitis (LC) reveals a pronounced intraepithelial lymphocytic (IEL) inflammation (20 per 100 surface epithelial cells) and an increased inflammatory infiltrate in the lamina propria but in the absence of a thickened collagen band (10 m). […] Incomplete microscopic colitis (MCi) comprises incomplete collagenous colitis (defined by a thickened subepithelial collagenous band 5 m but 10 m) and incomplete lymphocytic colitis (defined by 10 IELs but 20 IELs and a normal collagenous band). […] The criteria apply to hematoxylin and eosin (HE)-stained slides.

• #38 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies and Procedures

  https://emedicine.medscape.com/article/180664-workup

  Collagenous colitis (CC) demonstrates a thick colonic subepithelial collagenous deposit (10 m) and an increased inflammatory infiltrate in the lamina propria, whereas lymphocytic colitis (LC) reveals a pronounced intraepithelial lymphocytic (IEL) inflammation (20 per 100 surface epithelial cells) and an increased inflammatory infiltrate in the lamina propria but in the absence of a thickened collagen band (10 m). […] Incomplete microscopic colitis (MCi) comprises incomplete collagenous colitis (defined by a thickened subepithelial collagenous band 5 m but 10 m) and incomplete lymphocytic colitis (defined by 10 IELs but 20 IELs and a normal collagenous band). […] The criteria apply to hematoxylin and eosin (HE)-stained slides.

• #39 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies and Procedures

  https://emedicine.medscape.com/article/180664-workup

  Collagenous colitis (CC) demonstrates a thick colonic subepithelial collagenous deposit (10 m) and an increased inflammatory infiltrate in the lamina propria, whereas lymphocytic colitis (LC) reveals a pronounced intraepithelial lymphocytic (IEL) inflammation (20 per 100 surface epithelial cells) and an increased inflammatory infiltrate in the lamina propria but in the absence of a thickened collagen band (10 m). […] Incomplete microscopic colitis (MCi) comprises incomplete collagenous colitis (defined by a thickened subepithelial collagenous band 5 m but 10 m) and incomplete lymphocytic colitis (defined by 10 IELs but 20 IELs and a normal collagenous band). […] The criteria apply to hematoxylin and eosin (HE)-stained slides.

• #40 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Workup: Approach Considerations, Laboratory Studies, Imaging Studies and Procedures

  https://emedicine.medscape.com/article/180664-workup

  Collagenous colitis (CC) demonstrates a thick colonic subepithelial collagenous deposit (10 m) and an increased inflammatory infiltrate in the lamina propria, whereas lymphocytic colitis (LC) reveals a pronounced intraepithelial lymphocytic (IEL) inflammation (20 per 100 surface epithelial cells) and an increased inflammatory infiltrate in the lamina propria but in the absence of a thickened collagen band (10 m). […] Incomplete microscopic colitis (MCi) comprises incomplete collagenous colitis (defined by a thickened subepithelial collagenous band 5 m but 10 m) and incomplete lymphocytic colitis (defined by 10 IELs but 20 IELs and a normal collagenous band). […] The criteria apply to hematoxylin and eosin (HE)-stained slides.

• #41 A practical approach to histopathologic diagnosis of microscopic colitis

  http://www.scielo.org.co/scielo.php?pid=S0120-99572013000400006&script=sci_arttext&tlng=en

  The use of immunohistochemical techniques is not of vital importance for the diagnosis of LC because diagnosis can be done with routine hematoxylin-eosin (HE) staining. However, there are reports that conclude that in the appropriate clinical setting, the use of CD3 may have additional value for diagnosis of LC. […] Among the most common entities requiring differential diagnosis from LC are resolved acute active colitis, collagenous colitis, inflammatory bowel disease (IBD) and enteropathy associated with T-cells lymphoma. The presence of neutrophils indicates acute colitis which allows us to differentiate between LC, active self-limited colitis in the process of resolving itself, and active colitis overlapping with LC. […] By definition, CC is characterized by thickening of the subepithelial collagen band to a thickness of more than 10 microns. However, since measuring this band is time consuming and impractical, in addition to a description of increased thickness of the band, the key for diagnosis of CC is finding abnormal distribution of this band extending inside the lamina propria trapping capillaries and fibroblasts. HE staining does not always make the distribution pattern of collagen obvious. In these cases, Masson trichrome staining is quite helpful. The presence of an abnormal collagen band by itself is not sufficient to diagnose CC. Other characteristics should be present. These include increased mononuclear infiltrate in the lamina propria (in some cases with abundant eosinophils), increased IEL levels (smaller increases than in LC) and damage to the superficial epithelium.

• #42 The subtypes of microscopic colitis from a pathologist’s perspective: past, present and future

  https://atm.amegroups.org/article/view/13971/html

  The survey showed that in terms of HE stained colorectal biopsies with suspicion of CC: 67% of the respondents apply a non-immunohistochemical connective tissue staining, and 30% apply immunohistochemical staining (tenascin) in addition to HE-staining. […] A morphological suspicion of MC thus conspicuously increases the use of special stains/immunohistochemical stains among pathologists in Denmark. […] The study showed that intra- and interobserver agreement is high for discriminating cases of MC and MCi (CC, LC, CCi/LCi) from cases of non-MC (IBD/ infectious inflammation and normal), while the ability to discriminate MCi (CCi and LCi) from MC (CC and LC) was lower. […] Our study indicates that in cases of LC and LCi a supplementary CD3 staining increases the diagnostic agreement between pathologists; changes the diagnosis in a proportion of cases based on HE stained sections; reduces the number of cases primarily considered as LCi.

• #43 The subtypes of microscopic colitis from a pathologist’s perspective: past, present and future

  https://atm.amegroups.org/article/view/13971/html

  The survey showed that in terms of HE stained colorectal biopsies with suspicion of CC: 67% of the respondents apply a non-immunohistochemical connective tissue staining, and 30% apply immunohistochemical staining (tenascin) in addition to HE-staining. […] A morphological suspicion of MC thus conspicuously increases the use of special stains/immunohistochemical stains among pathologists in Denmark. […] The study showed that intra- and interobserver agreement is high for discriminating cases of MC and MCi (CC, LC, CCi/LCi) from cases of non-MC (IBD/ infectious inflammation and normal), while the ability to discriminate MCi (CCi and LCi) from MC (CC and LC) was lower. […] Our study indicates that in cases of LC and LCi a supplementary CD3 staining increases the diagnostic agreement between pathologists; changes the diagnosis in a proportion of cases based on HE stained sections; reduces the number of cases primarily considered as LCi.

• #44 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  The pathognomonic finding on biopsies in lymphocytic colitis is an intraepithelial lymphocytosis, defined as 20 or more intraepithelial lymphocytes (IEL) per 100 surface epithelial cells with a mixed infiltrate of acute and chronic inflammatory cells present in the lamina propria and a normal collagenous band (5 M), typically without crypt distortion. […] However, mixed cases exist where histological changes of collagenous colitis are observed in some colonic segments, whereas other segments show changes of lymphocytic colitis. […] Therefore, it is uncertain whether the two histological forms are really different entities or whether they could be different stages of a single pathological process, a phase of the process, or an individual response to different triggers.

• #45 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  The pathognomonic finding on biopsies in lymphocytic colitis is an intraepithelial lymphocytosis, defined as 20 or more intraepithelial lymphocytes (IEL) per 100 surface epithelial cells with a mixed infiltrate of acute and chronic inflammatory cells present in the lamina propria and a normal collagenous band (5 M), typically without crypt distortion. […] However, mixed cases exist where histological changes of collagenous colitis are observed in some colonic segments, whereas other segments show changes of lymphocytic colitis. […] Therefore, it is uncertain whether the two histological forms are really different entities or whether they could be different stages of a single pathological process, a phase of the process, or an individual response to different triggers.

• #46 Microscopic colitis: Etiopathology, diagnosis, and rational management | eLife

  https://elifesciences.org/articles/79397

  A recent analysis confirmed a synchronous occurrence of microscopic colitis and IBD and transitions between the two diagnoses. […] Therefore, it is uncertain whether the two histological forms are really different entities or whether they could be different stages of a single pathological process, a phase of the process, or an individual response to different triggers.

• #47 Microscopic colitis – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/microscopic-colitis/

  Microscopic colitis (MC) is an inflammatory disease of the bowel. It is characterised by watery diarrhoea, usually accompanied by urgency and problems with bowel control. […] This condition is thought to be under-diagnosed, which means people with these symptoms might have microscopic colitis that has been mistakenly identified for another condition. Most often it is misdiagnosed as IBS or diverticular disease. […] Unlike other inflammatory bowel diseases (IBD), like Crohn’s disease or ulcerative colitis, the lining of the bowel appears normal when investigated with a colonoscope (a flexible tube with a camera at the end used to examine the inside of the bowel). […] Therefore, a normal result can falsely reassure individuals that it is not microscopic colitis. But it is only when a biopsy (a small tissue sample) of the bowel is taken and examined under the microscope can the inflammation be seen.

• #48 Diagnosis of Microscopic Colitis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/microscopic-colitis/diagnosis.html

  The best way to diagnose your condition is by examining a tissue sample (biopsy) of your colon under a microscope. […] The IBD team at Stanford Health Care works seamlessly with doctors who specialize in interpreting colon biopsies (clinical pathologists) to offer a precise diagnosis for your condition. […] As part of our comprehensive approach to care, we also try to rule out other conditions that cause diarrhea, such as viruses and food intolerances. […] To do this, you may need one or more of the following tests, including: […] Colonoscopy or sigmoidoscopy: Examining the entire length of your colon (colonoscopy) or just the lower part of your colon (sigmoidoscopy) with the help of a small flexible tube and tiny camera we insert into your rectum (endoscope). […] Stool culture: Also known as a fecal occult blood test (FOBT), this test can identify microscopic amounts of blood, white blood cells and evidence of food intolerances.

• #49 Microscopic colitis – Wikipedia

  https://en.wikipedia.org/wiki/Microscopic_colitis

  Microscopic colitis refers to two related medical conditions which cause diarrhea: collagenous colitis and lymphocytic colitis. Both conditions are characterized by the presence of chronic non-bloody watery diarrhea, normal appearances on colonoscopy and characteristic histopathology findings of inflammatory cells. […] Microscopic colitis is the diagnosis in around 10% of cases investigated for chronic non-bloody diarrhea. […] Colonoscopic appearances are normal or near normal. As the changes are often patchy, an examination limited to the rectum may miss cases of microscopic colitis, and so a full colonoscopy is necessary. Multiple colonic biopsies are taken in order to make the diagnosis. Histological features of colonic biopsies indicating microscopic colitis are: greater than 20 intraepithelial lymphocytes per 100 epithelial cells and, additionally, 10-20 m of a thickened subepithelial collagen band in collagenous colitis. […] Differential diagnoses, which should be ruled out, include bile acid diarrhea, lactose malabsorption, celiac disease, Crohn’s disease, ulcerative colitis, and infectious colitis. […] Diagnosis and management of microscopic colitis: current perspectives.

• #50 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Differential Diagnoses

  https://emedicine.medscape.com/article/180664-differential

  Patients clinically assessed as having diarrhea-predominant IBS (IBS-D) in whom conventional medical therapy is refractory may in fact have microscopic colitis, and these patients may benefit from colonoscopy with biopsies. […] Limit biopsies to those subgroups of patients in whom microscopic colitis is most likely, such as patients with watery, severe, debilitating, or nocturnal diarrhea; substantial weight loss; an elevated erythrocyte sedimentation rate; or patients who are immunosuppressed.

• #51 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Differential Diagnoses

  https://emedicine.medscape.com/article/180664-differential

  Rule out microscopic colitis (MC) in those who fulfill the criteria for functional bowel disease, especially in the presence of risk factors for microscopic colitis and/or in the absence of response to therapy for irritable bowel syndrome (IBS). […] Microscopic colitis should be considered as a differential diagnosis in the workup of chronic diarrhea, especially in the elderly population. In addition, microscopic colitis should be considered in patients diagnosed with celiac disease who have diarrhea that fails to respond to a gluten-free diet. […] Patients whose condition fails to respond to reasonable medical therapy should be evaluated for other conditions that may clinically mimic lymphocytic colitis and collagenous colitis. […] Performing a colonoscopy on patients with chronic diarrhea is commonly accepted and widely practiced, but performing biopsies in all such individuals has a low yield, even with normal findings on endoscopy.

• #52 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  The pathologist should be encouraged to use objective histological criteria to make the diagnosis. […] The three determinants of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Specific tests can rule out conditions such as medication-induced diarrhea, intestinal malabsorptive disorders, small intestinal bacterial overgrowth, infection by Clostridium difficile, and inflammatory bowel disease (IBD). […] Diagnosis of MC necessitates effective communication among gastroenterologists, endoscopists, and pathologists. It is critical to mention the suspicion of MC when requesting the workup and referring the biopsy. […] Recommendation: if the gastroenterologist has a strong clinical suspicion of MC and the biopsy result is inconclusive, the slides should be reviewed by a pathologist who specializes in gastrointestinal disorders.

• #53 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  The pathologist should be encouraged to use objective histological criteria to make the diagnosis. […] The three determinants of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Specific tests can rule out conditions such as medication-induced diarrhea, intestinal malabsorptive disorders, small intestinal bacterial overgrowth, infection by Clostridium difficile, and inflammatory bowel disease (IBD). […] Diagnosis of MC necessitates effective communication among gastroenterologists, endoscopists, and pathologists. It is critical to mention the suspicion of MC when requesting the workup and referring the biopsy. […] Recommendation: if the gastroenterologist has a strong clinical suspicion of MC and the biopsy result is inconclusive, the slides should be reviewed by a pathologist who specializes in gastrointestinal disorders.

• #54 Microscopic colitis – could it be caused by a medicine?

  https://www.medsafe.govt.nz/profs/PUArticles/December2022/Microscopic-colitis-could-it-be-caused-by-a-medicine.html

  Microscopic colitis causes chronic, watery, non-bloody diarrhoea. […] Consider medicines as a possible cause of microscopic colitis. […] Microscopic colitis is an inflammatory disease of the colon that causes chronic, watery, non-bloody diarrhoea. […] There is evidence that a mucosal immune response occurs in genetically predisposed individuals and may contribute to the development of microscopic colitis. […] Diarrhoea associated with microscopic colitis is likely caused by mucosal inflammation. […] Microscopic colitis predominantly affects females and should be considered a possible cause of chronic diarrhoea, especially in middle-aged and older adults. […] Collagenous colitis is diagnosed in cases where a broad subepithelial fibrous band is observed on histology. […] Lymphocytic colitis is diagnosed when an infiltration of more than 20 intraepithelial lymphocytes per 100 epithelial cells is observed. […] Biopsies confirm a diagnosis. […] Healthcare professionals should consider such medicines as a possible cause of microscopic colitis.

• #55 Microscopic Colitis

  https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/understanding-crohns-and-colitis/microscopic-colitis

  It may take time to diagnose Microscopic Colitis. This is because the condition is not always as well-recognised as other forms of Inflammatory Bowel Disease. […] A poo test, or faecal calprotectin test is not always helpful in finding Microscopic Colitis. […] Your large bowel looks normal at colonoscopy. A biopsy is needed to find Microscopic Colitis. […] If your healthcare professional thinks your Microscopic Colitis is related to BAM, you may be sent for a special test called a SeHCAT scan.

• #56 Microscopic colitis – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/microscopic-colitis/

  Diagnosis can be easier if more symptoms and signs are considered, in addition to the presence of watery diarrhoea. […] If symptoms continue then alternative diagnosis should be considered by your doctor, for example coeliac disease, lactose intolerance and bile acid diarrhoea. This strengthens the case for better diagnosis of this condition, which Guts UK hopes will happen through raising awareness among the public and health professionals.

• #57 Microscopic colitis – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/microscopic-colitis/

  Microscopic colitis (MC) is an inflammatory disease of the bowel. It is characterised by watery diarrhoea, usually accompanied by urgency and problems with bowel control. […] This condition is thought to be under-diagnosed, which means people with these symptoms might have microscopic colitis that has been mistakenly identified for another condition. Most often it is misdiagnosed as IBS or diverticular disease. […] Unlike other inflammatory bowel diseases (IBD), like Crohn’s disease or ulcerative colitis, the lining of the bowel appears normal when investigated with a colonoscope (a flexible tube with a camera at the end used to examine the inside of the bowel). […] Therefore, a normal result can falsely reassure individuals that it is not microscopic colitis. But it is only when a biopsy (a small tissue sample) of the bowel is taken and examined under the microscope can the inflammation be seen.

• #58 Microscopic colitis – could it be caused by a medicine?

  https://www.medsafe.govt.nz/profs/PUArticles/December2022/Microscopic-colitis-could-it-be-caused-by-a-medicine.html

  Microscopic colitis causes chronic, watery, non-bloody diarrhoea. […] Consider medicines as a possible cause of microscopic colitis. […] Microscopic colitis is an inflammatory disease of the colon that causes chronic, watery, non-bloody diarrhoea. […] There is evidence that a mucosal immune response occurs in genetically predisposed individuals and may contribute to the development of microscopic colitis. […] Diarrhoea associated with microscopic colitis is likely caused by mucosal inflammation. […] Microscopic colitis predominantly affects females and should be considered a possible cause of chronic diarrhoea, especially in middle-aged and older adults. […] Collagenous colitis is diagnosed in cases where a broad subepithelial fibrous band is observed on histology. […] Lymphocytic colitis is diagnosed when an infiltration of more than 20 intraepithelial lymphocytes per 100 epithelial cells is observed. […] Biopsies confirm a diagnosis. […] Healthcare professionals should consider such medicines as a possible cause of microscopic colitis.

• #59 Microscopic Colitis

  https://crohnsandcolitis.org.uk/info-support/information-about-crohns-and-colitis/all-information-about-crohns-and-colitis/understanding-crohns-and-colitis/microscopic-colitis

  It may take time to diagnose Microscopic Colitis. This is because the condition is not always as well-recognised as other forms of Inflammatory Bowel Disease. […] A poo test, or faecal calprotectin test is not always helpful in finding Microscopic Colitis. […] Your large bowel looks normal at colonoscopy. A biopsy is needed to find Microscopic Colitis. […] If your healthcare professional thinks your Microscopic Colitis is related to BAM, you may be sent for a special test called a SeHCAT scan.

• #60 Microscopic colitis – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/microscopic-colitis/

  Microscopic colitis (MC) is an inflammatory disease of the bowel. It is characterised by watery diarrhoea, usually accompanied by urgency and problems with bowel control. […] This condition is thought to be under-diagnosed, which means people with these symptoms might have microscopic colitis that has been mistakenly identified for another condition. Most often it is misdiagnosed as IBS or diverticular disease. […] Unlike other inflammatory bowel diseases (IBD), like Crohn’s disease or ulcerative colitis, the lining of the bowel appears normal when investigated with a colonoscope (a flexible tube with a camera at the end used to examine the inside of the bowel). […] Therefore, a normal result can falsely reassure individuals that it is not microscopic colitis. But it is only when a biopsy (a small tissue sample) of the bowel is taken and examined under the microscope can the inflammation be seen.

• #61 Microscopic colitis – Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/microscopic-colitis/

  Microscopic colitis (MC) is an inflammatory disease of the bowel. It is characterised by watery diarrhoea, usually accompanied by urgency and problems with bowel control. […] This condition is thought to be under-diagnosed, which means people with these symptoms might have microscopic colitis that has been mistakenly identified for another condition. Most often it is misdiagnosed as IBS or diverticular disease. […] Unlike other inflammatory bowel diseases (IBD), like Crohn’s disease or ulcerative colitis, the lining of the bowel appears normal when investigated with a colonoscope (a flexible tube with a camera at the end used to examine the inside of the bowel). […] Therefore, a normal result can falsely reassure individuals that it is not microscopic colitis. But it is only when a biopsy (a small tissue sample) of the bowel is taken and examined under the microscope can the inflammation be seen.

• #62 Microscopic colitis: Etiopathology, diagnosis, and rational management

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9342949/

  In a recent systematic review aimed at determining the optimal sites and minimum number of colonic biopsies required to diagnose microscopic colitis from published studies, it was concluded that a minimum of six biopsies should be obtained in total (three from the ascending and three from the descending colon). […] The histological findings of microscopic colitis are, however, not uniform throughout the colon as the changes are more prominent in the proximal part of colon. […] The minimal required histopathological criteria for the subtypes of microscopic colitis seem to be achieved in 90% of the left-sided biopsies (rectum excluded), demonstrating a pancolitis in most patients with microscopic colitis. […] In this context, it has been revealed that a flexible sigmoidoscopy is often inadequate and may miss the diagnosis in 20% of all patients if biopsies are not obtained above the rectosigmoid colon.

• #63 Microscopic colitis: Etiopathology, diagnosis, and rational management | eLife

  https://elifesciences.org/articles/79397

  Microscopic colitis is an inflammatory bowel disease divided into two subtypes: collagenous colitis and lymphocytic colitis. […] Therefore, physicians should be familiar with its clinical features and management strategies because the disease deserves the same attention as the classical inflammatory bowel diseases. […] Here, state-of-the-art knowledge of microscopic colitis is provided from a global perspective with reference to etiopathology and how to establish the diagnosis with the overall aim to create awareness and improve rational management in clinical practice. […] As biomarkers are absent, the diagnosis relies on colonoscopy with a histological assessment of biopsy specimens from all parts of the colon. […] The diagnosis of microscopic colitis is based on a full colonoscopy with histopathological assessment of multiple random biopsies obtained from the entire colon despite endoscopic absence of any macroscopic abnormalities.

• #64 Microscopic Colitis – Crohn’s & Colitis Australia (CCA)

  https://crohnsandcolitis.org.au/about-crohns-colitis/other-types-of-ibd/about-microscopic-colitis/

  Microscopic colitis is a less common inflammatory bowel disease (IBD) that causes inflammation in the large intestine. […] Inflammation caused by microscopic colitis cannot be seen with the naked eye – tissue from the gut must be examined under a microscope. […] Microscopic colitis is less well known by both health professionals and the general public so it can be difficult to get a diagnosis. […] To diagnose the condition a small tissue sample (biopsy) is taken from the colon when you have a colonoscopy. This is then looked at under a microscope. […] The doctor won’t be able to see any visible signs of inflammation when they look at your colon and rectum. This is different from Crohn’s or ulcerative colitis when inflammation or ulcers can be seen. […] It may take some time to get a diagnosis of microscopic colitis, and this can be frustrating. […] A poo test (faecal calprotectin) isn’t usually helpful – this finds evidence of inflammation in the gut, but with microscopic colitis levels are often quite low. […] Your colon and rectum will look normal at colonoscopy – it is vital to take biopsies to find microscopic colitis.

• #65 Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl17061

  Microscopic colitis (MC), which is comprised of lymphocytic colitis and collagenous colitis, is a clinicopathological diagnosis that is commonly encountered in clinical practice during the evaluation and management of chronic diarrhea. With an incidence approaching the incidence of inflammatory bowel disease, physician awareness is necessary, as diagnostic delays result in a poor quality of life and increased health care costs. […] The diagnosis of MC involves the combination of clinical presentation with histologic changes. Generally, a patient will undergo a colonoscopy to evaluate the presence of chronic watery diarrhea. The endoscopic appearance unlike with IBD may be normal to near normal with rare cases of superficial mucosal cracking or nonspecific erythema. It is a combination of histologic changes with the proper clinical context that helps the pathologist to make the diagnosis histologically; however, histologic findings are not validated nor pathognomonic.

• #66 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  Microscopic colitis is a chronic inflammatory bowel disease characterized by non-bloody diarrhea that can range from mild to severe. The three determinants factors of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Diagnosis of microscopic colitis necessitates effective communication among gastroenterologists, endoscopists, and pathologists. […] The gastroenterologist should refer every patient with chronic watery diarrhea to perform a colonoscopy in spite of the benign course of the disease and the absence of alarm symptoms. […] The endoscopist should take 2 or 3 biopsy samples of the colonic mucosa from the right and left colon, put in separate recipients, despite that the mucosa looked macroscopically normal.

• #67 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  Microscopic colitis is a chronic inflammatory bowel disease characterized by non-bloody diarrhea that can range from mild to severe. The three determinants factors of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Diagnosis of microscopic colitis necessitates effective communication among gastroenterologists, endoscopists, and pathologists. […] The gastroenterologist should refer every patient with chronic watery diarrhea to perform a colonoscopy in spite of the benign course of the disease and the absence of alarm symptoms. […] The endoscopist should take 2 or 3 biopsy samples of the colonic mucosa from the right and left colon, put in separate recipients, despite that the mucosa looked macroscopically normal.

• #68 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  Microscopic colitis is a chronic inflammatory bowel disease characterized by non-bloody diarrhea that can range from mild to severe. The three determinants factors of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Diagnosis of microscopic colitis necessitates effective communication among gastroenterologists, endoscopists, and pathologists. […] The gastroenterologist should refer every patient with chronic watery diarrhea to perform a colonoscopy in spite of the benign course of the disease and the absence of alarm symptoms. […] The endoscopist should take 2 or 3 biopsy samples of the colonic mucosa from the right and left colon, put in separate recipients, despite that the mucosa looked macroscopically normal.

• #69 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  The pathologist should be encouraged to use objective histological criteria to make the diagnosis. […] The three determinants of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Specific tests can rule out conditions such as medication-induced diarrhea, intestinal malabsorptive disorders, small intestinal bacterial overgrowth, infection by Clostridium difficile, and inflammatory bowel disease (IBD). […] Diagnosis of MC necessitates effective communication among gastroenterologists, endoscopists, and pathologists. It is critical to mention the suspicion of MC when requesting the workup and referring the biopsy. […] Recommendation: if the gastroenterologist has a strong clinical suspicion of MC and the biopsy result is inconclusive, the slides should be reviewed by a pathologist who specializes in gastrointestinal disorders.

• #70 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  The pathologist should be encouraged to use objective histological criteria to make the diagnosis. […] The three determinants of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Specific tests can rule out conditions such as medication-induced diarrhea, intestinal malabsorptive disorders, small intestinal bacterial overgrowth, infection by Clostridium difficile, and inflammatory bowel disease (IBD). […] Diagnosis of MC necessitates effective communication among gastroenterologists, endoscopists, and pathologists. It is critical to mention the suspicion of MC when requesting the workup and referring the biopsy. […] Recommendation: if the gastroenterologist has a strong clinical suspicion of MC and the biopsy result is inconclusive, the slides should be reviewed by a pathologist who specializes in gastrointestinal disorders.

• #71 SciELO Brazil – MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS MICROSCOPIC COLITIS: CONSIDERATIONS FOR GASTROENTEROLOGISTS, ENDOSCOPISTS, AND PATHOLOGISTS

  https://www.scielo.br/j/ag/a/HjStPWzMDk9gStWD9Xx5jhr/

  The pathologist should be encouraged to use objective histological criteria to make the diagnosis. […] The three determinants of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. […] Specific tests can rule out conditions such as medication-induced diarrhea, intestinal malabsorptive disorders, small intestinal bacterial overgrowth, infection by Clostridium difficile, and inflammatory bowel disease (IBD). […] Diagnosis of MC necessitates effective communication among gastroenterologists, endoscopists, and pathologists. It is critical to mention the suspicion of MC when requesting the workup and referring the biopsy. […] Recommendation: if the gastroenterologist has a strong clinical suspicion of MC and the biopsy result is inconclusive, the slides should be reviewed by a pathologist who specializes in gastrointestinal disorders.

• #72 The subtypes of microscopic colitis from a pathologist’s perspective: past, present and future

  https://atm.amegroups.org/article/view/13971/html

  Automated image analysis may also contribute to achieve uniform histopathological diagnosis in multicenter studies provided the stains used by the contributors are identical. […] The exact disease course of MC is largely unknown and prospective studies are needed. […] The PRO-MC collaboration has the potential to serve as a basis for several future research topics.

• #73 Diagnosis and management of microscopic colitis: current perspectives | CEG

  https://www.dovepress.com/diagnosis-and-management-of-microscopic-colitis-current-perspectives-peer-reviewed-fulltext-article-CEG

  Microscopic colitis (MC), a mutual term for a group of inflammatory disorders of the colon described and evolving during the past few decades, has emerged as a common cause of chronic nonbloody diarrhea. […] As the name indicates, the condition can be diagnosed only by microscopic assessment of colonic mucosal biopsies. […] The diagnosis of MC relies only on findings of characteristic histopathologic features in colonic mucosal biopsies. […] Routine laboratory tests are nondiagnostic, and only nonspecific abnormalities may be found, such as moderately increased levels of C-reactive protein, erythrocyte-sedimentation rate, or mild anemia. […] The diagnostic accuracy of fecal calprotectin and lactoferrin is low in MC in contrast to ulcerative colitis and Crohns disease. […] Therefore, there has been a search for alternative biomarkers reflecting mucosal inflammation.

• #74 Microscopic Colitis (Collagenous and Lymphocytic Colitis) Differential Diagnoses

  https://emedicine.medscape.com/article/180664-differential

  Patients clinically assessed as having diarrhea-predominant IBS (IBS-D) in whom conventional medical therapy is refractory may in fact have microscopic colitis, and these patients may benefit from colonoscopy with biopsies. […] Limit biopsies to those subgroups of patients in whom microscopic colitis is most likely, such as patients with watery, severe, debilitating, or nocturnal diarrhea; substantial weight loss; an elevated erythrocyte sedimentation rate; or patients who are immunosuppressed.

• #75 Microscopic Colitis: Pathogenesis and Diagnosis

  https://www.mdpi.com/2077-0383/12/13/4442

  Microscopic colitis is a type of inflammatory bowel disease and is classified as either collagenous colitis or lymphocytic colitis. The typical presentation is chronic watery diarrhea. […] The diagnosis of microscopic colitis depends on histological tissue obtained during colonoscopy. […] Current literature suggests that the histological findings may be patchy and not continuous throughout the colon and that it is the most severe in the proximal part of the colon. […] The European guideline strongly recommends that ileocolonoscopy should be performed in patients with suspected microscopic colitis and that biopsies should be taken from the right and the left side of the colon. […] The tissue obtained only from flexible sigmoidoscopy had low sensitivity and specificity. […] The current diagnostic guideline relies on histological tissue obtained from colonoscopy. However, many studies have proposed laboratory markers and fecal biomarkers to help with the diagnosis of microscopic colitis. […] The pathogenesis of microscopic colitis remains unknown and is likely complex and multifactorial. […] The management of microscopic colitis should be based on each individual’s underlying pathogenesis and involves budesonide, bile acid sequestrants, or immunosuppressive drugs in refractory cases.

• #76 Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl17061

  Microscopic colitis (MC), which is comprised of lymphocytic colitis and collagenous colitis, is a clinicopathological diagnosis that is commonly encountered in clinical practice during the evaluation and management of chronic diarrhea. With an incidence approaching the incidence of inflammatory bowel disease, physician awareness is necessary, as diagnostic delays result in a poor quality of life and increased health care costs. […] The diagnosis of MC involves the combination of clinical presentation with histologic changes. Generally, a patient will undergo a colonoscopy to evaluate the presence of chronic watery diarrhea. The endoscopic appearance unlike with IBD may be normal to near normal with rare cases of superficial mucosal cracking or nonspecific erythema. It is a combination of histologic changes with the proper clinical context that helps the pathologist to make the diagnosis histologically; however, histologic findings are not validated nor pathognomonic.

• #77

  https://link.springer.com/article/10.1007/s40266-023-01094-6

  Thus, a combination of clinical symptoms (watery diarrhea, urgency, and often bloating) and histological findings are needed to reach the diagnosis of microscopic colitis. […] A correct diagnosis is crucial for the appropriate treatment of microscopic colitis and for differentiating this condition from other conditions with similar symptoms.

• #78 Diagnosis of Microscopic Colitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis/diagnosis

  To help diagnose microscopic colitis, your doctor will ask about your symptoms and medical history and will perform a physical exam. […] Your doctor may order medical tests, such as blood and stool tests, to check for signs of conditions that cause symptoms similar to those of microscopic colitis. […] Doctors order a colonoscopy with biopsies to diagnose microscopic colitis and rule out other digestive conditions. […] To diagnose microscopic colitis, a pathologist will examine the tissue under a microscope to check for signs of the disease.

• #79 Diagnosis of Microscopic Colitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis/diagnosis

  To help diagnose microscopic colitis, your doctor will ask about your symptoms and medical history and will perform a physical exam. […] Your doctor may order medical tests, such as blood and stool tests, to check for signs of conditions that cause symptoms similar to those of microscopic colitis. […] Doctors order a colonoscopy with biopsies to diagnose microscopic colitis and rule out other digestive conditions. […] To diagnose microscopic colitis, a pathologist will examine the tissue under a microscope to check for signs of the disease.

• #80 Diagnosis of Microscopic Colitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis/diagnosis

  To help diagnose microscopic colitis, your doctor will ask about your symptoms and medical history and will perform a physical exam. […] Your doctor may order medical tests, such as blood and stool tests, to check for signs of conditions that cause symptoms similar to those of microscopic colitis. […] Doctors order a colonoscopy with biopsies to diagnose microscopic colitis and rule out other digestive conditions. […] To diagnose microscopic colitis, a pathologist will examine the tissue under a microscope to check for signs of the disease.

• #81 Diagnosis of Microscopic Colitis – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis/diagnosis

  To help diagnose microscopic colitis, your doctor will ask about your symptoms and medical history and will perform a physical exam. […] Your doctor may order medical tests, such as blood and stool tests, to check for signs of conditions that cause symptoms similar to those of microscopic colitis. […] Doctors order a colonoscopy with biopsies to diagnose microscopic colitis and rule out other digestive conditions. […] To diagnose microscopic colitis, a pathologist will examine the tissue under a microscope to check for signs of the disease.

• #82 Diagnosis of Microscopic Colitis | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/microscopic-colitis/diagnosis.html

  The best way to diagnose your condition is by examining a tissue sample (biopsy) of your colon under a microscope. […] The IBD team at Stanford Health Care works seamlessly with doctors who specialize in interpreting colon biopsies (clinical pathologists) to offer a precise diagnosis for your condition. […] As part of our comprehensive approach to care, we also try to rule out other conditions that cause diarrhea, such as viruses and food intolerances. […] To do this, you may need one or more of the following tests, including: […] Colonoscopy or sigmoidoscopy: Examining the entire length of your colon (colonoscopy) or just the lower part of your colon (sigmoidoscopy) with the help of a small flexible tube and tiny camera we insert into your rectum (endoscope). […] Stool culture: Also known as a fecal occult blood test (FOBT), this test can identify microscopic amounts of blood, white blood cells and evidence of food intolerances.

• #83

  https://link.springer.com/article/10.1007/s40266-023-01094-6

  Thus, a combination of clinical symptoms (watery diarrhea, urgency, and often bloating) and histological findings are needed to reach the diagnosis of microscopic colitis. […] A correct diagnosis is crucial for the appropriate treatment of microscopic colitis and for differentiating this condition from other conditions with similar symptoms.

• #84 SciELO Brazil – DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROLOGY DIAGNOSIS AND TREATMENT OF MICROSCOPIC COLITIS: POSITION PAPER ON BEHALF OF THE BRAZILIAN FEDERATION OF GASTROENTEROL

  https://www.scielo.br/j/ag/a/tPZKRdCPbYCzSSxdgHZfwKL/

  Budesonide is the standard first-line therapy for inducing remission in MC due to its efficacy, favorable tolerability profile and minimal systemic side effects. […] The primary therapeutic goal in microscopic colitis is clinical remission. Currently, there is insufficient evidence to support routine endoscopic and histological monitoring following treatment. […] Patients with suspected MC should perform laboratory evaluations to rule out other causes of chronic diarrhea. […] The need for long-term follow-up is highlighted due to the high recurrence rates and the impact of MC on the quality of life.

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