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What is microscopic colitis? — Microscopic colitis is a condition that causes watery diarrhea. It involves the colon, which is another name for the large intestine (figure 1). There are 2 types of microscopic colitis, "lymphocytic colitis" and "collagenous colitis." Both types cause the same symptoms and are treated the same way.
Microscopic colitis happens when the colon gets inflamed. But doctors don't always know what makes the colon inflamed. In some cases, the condition seems to be triggered by an infection in the digestive system. In other cases, it seems to be caused by medicines. For example, a group of medicines called nonsteroidal antiinflammatory drugs ("NSAIDs") sometimes causes microscopic colitis.
Microscopic colitis happens most often in adults age 45 and older. Although the symptoms are bothersome, the condition is not life-threatening. It does not lead to serious problems, like cancer.
What are the symptoms of microscopic colitis? — Microscopic colitis causes episodes of diarrhea that is watery and not bloody. Most people have 4 to 9 watery bowel movements a day, but some people have more. Diarrhea can last weeks to months.
People sometimes have other symptoms, too. These commonly include weight loss, belly pain, or feeling very tired.
Is there a test for microscopic colitis? — Yes. Your doctor or nurse will do an exam and order different tests to exclude other causes of diarrhea and diagnose microscopic colitis. These can include:
●Blood tests
●Lab tests on a sample of your bowel movement
●Colonoscopy or flexible sigmoidoscopy – These are procedures that let the doctor look at the inside of your colon. The doctor puts a thin tube with a camera and light on the end into your anus and up into your rectum and colon (figure 2).
During this procedure, the doctor will do a test called a biopsy. This involves taking small samples of tissue from your colon. Then, another doctor looks at the samples under a microscope to check for microscopic colitis. A biopsy is the only test that can tell for sure whether you have microscopic colitis.
How is microscopic colitis treated? — Treatment depends on your individual situation. It usually involves 1 or more of the following:
●Medicine changes – If your doctor thinks that a medicine is causing your symptoms, they will recommend that you stop taking that medicine.
●Anti-diarrhea medicines – These medicines reduce the number of bowel movements that you have. An example is loperamide (brand name: Imodium).
●Steroid medicine called budesonide (brand name: Entocort) – This medicine helps reduce inflammation in the colon.
If these treatments don't help enough to ease your symptoms, tell your doctor or nurse. There are other medicines or treatments that might help.
Some people need treatment for a long time. That's because symptoms sometimes come back after treatment is stopped.
Patient education: Diarrhea in teens and adults (The Basics)
Patient education: Colonoscopy (The Basics)
Patient education: Celiac disease (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)
Patient education: Colitis (The Basics)
Patient education: Chronic diarrhea in adults (Beyond the Basics)
Patient education: Colonoscopy (Beyond the Basics)
Patient education: Celiac disease in adults (Beyond the Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)
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