Know the basics
What is microscopic colitis?
Microscopic colitis is a genetic disease occurs when inflammation of the large intestine (colon) appears and causes persistent watery diarrhea.
There are two types of microscopic colitis:
- Collagenous colitis, in which a thick layer of protein (collagen) develops in colon tissue when observed by microscope;
- Lymphocytic colitis, in which white blood cells (lymphocytes) increase in colon tissue when observed by microscope.
How common is microscopic colitis?
More women than men have collagenous colitis; lymphocytic colitis affects men and women equally. People are usually first diagnosed in their 50s or 60s. You can minimize the chance of having hernias by reducing your risk factors. Please discuss with your doctor for further information.
Know the symptoms
What are the symptoms of microscopic colitis?
The main symptom is chronic watery, non-bloody diarrhea. It often starts quite suddenly.Diarrhea may be constant or come and go. Other symptoms are:
- Pain, cramps, or bloating in the abdomen (belly);
- Weight loss;
- Fecal incontinence causing dehydration.
There may be some signs or symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have watery diarrhea that lasts more than a few days, contact your doctor so that your condition can be diagnosed and properly treated. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
Know the causes
What causes microscopic colitis?
It’s not clear what causes the inflammation of the colon found in microscopic colitis. Researchers believe that the causes may include:
- Medications that can irritate the lining of the colon;
- Bacteria that produce toxins that irritate the lining of the colon;
- Viruses that trigger inflammation;
- Immune system problems, such as rheumatoid arthritis or celiac disease, that occur when your body’s immune system attacks healthy tissues.
Know the risk factors
What increases my risk for microscopic colitis?
What increases your risk for microscopic colitis?
Risk factors for microscopic colitis include:
- Age and gender. Microscopic colitis is most common in people ages 50 to 70 and more common in women than men.
- Immune system problems. People with microscopic colitis sometimes also have an autoimmune disorder, such as celiac disease, thyroid disease or rheumatoid arthritis.
- Smoking. Recent research studies have shown an association between tobacco smoking and microscopic colitis, especially in people ages 16 to 44.
Some research studies indicate that using certain medications may increase your risk of microscopic colitis. But not all studies agree. Medications linked to the condition include:
- Aspirin, acetaminophen (®Tylenol, others), and ibuprofen (®Advil,®Motrin IB, others);
- Proton pump inhibitors, including lansoprazole;
- Acarbose (®Precose);
- Ranitidine (®Zantac);
- Selective serotonin reuptake inhibitors, such as sertraline (®Zoloft);
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is microscopic colitis diagnosed?
Lifestyle changes to stop diarrhea are usually tried first. The amount of fat in the diet is reduced, foods that contain caffeine or lactose are avoided, and NSAIDs are stopped.
If these changes aren’t enough, drugs are tried. Medicines such as bismuth sub-salicylate (®Pepto-Bismol), loperamide (®Imodium), or the combination diphenoxylate and atropine (®Lomotil) may help diarrhea. Bulking agents (psyllium, methylcellulose) may also help. Anti-inflammatory medicines, such as mesalamine, sulfasalazine, and steroids including budesonide, reduce inflammation.
How is microscopic colitis treated?
The doctor may suspect microscopic diarrhea based on the medical history and physical exam. In addition, other tests may be done include:
- Stool test or blood test;
- Endoscopic biopsy;
- Internal sigmoidoscopy.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage microscopic colitis?
The following lifestyles and home remedies might help you cope with microscopic colitis :
- Avoid eating problem foods such as fat, caffeine, and lactose (milk sugar found in dairy products). Avoid spicy foods and alcohol. Stay away from foods that cause gas and diarrhea: carbonated beverages, raw fruits, and vegetables such as beans, cauliflower, broccoli, and cabbage.
- Talk to your doctor about using pain relievers other than NSAIDs. NSAIDs can worsen diarrhea.
- Ask your doctor whether you should drink an oral rehydration solution (ORS). Severe diarrhea can cause dehydration. An ORS has the right amounts of water, salts, and sugar to replace body fluids.
- Look into eating a gluten-free diet. Microscopic colitis may respond to this diet.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: May 30, 2016 | Last Modified: January 4, 2017
Ferri, Fred. Ferri’s Netter Patient Advisor. Philadelphia, PA: Saunders / Elsevier, 2012. Download version.
Porter, R. S., Kaplan, J. L., Homeier, B. P., & Albert, R. K. (2009). The Merck manual home health handbook. Whitehouse Station, NJ, Merck Research Laboratories. Page 593.
Microscopic colitis. http://www.mayoclinic.org/diseases-conditions/microscopic-colitis/basics/definition/con-20026232. Accessed August 12, 2016.