Microscopic colitis is not associated with cholecystectomy or appendectomy.
BACKGROUND
Microscopic colitis is a common cause of chronic watery diarrhea of unknown origin. Some patients develop diarrhea after cholecystectomy, and some patients with microscopic colitis have evidence of bile acid malabsorption. However, the association between cholecystectomy and microscopic colitis has not been studied. A protective effect of appendectomy on the development of ulcerative colitis also has been reported, but its relationship with microscopic colitis has not been studied. The aim of this study was to assess cholecystectomy and appendectomy as potential risk factors for the development of microscopic colitis in a nested case-control study.


METHODS
Using the Rochester Epidemiology Project, we identified all Olmsted County (Minnesota) residents with an initial diagnosis of microscopic colitis between January 1, 1985, and December 31, 2001. Rates of antecedent cholecystectomy or appendectomy in patients with microscopic colitis were compared with age-, gender-, and calendar year-matched community controls through conditional logistic regression.


RESULTS
Microscopic colitis was identified in 130 cases. Cholecystectomy preceded the diagnosis of microscopic colitis in 12 cases (9%) compared with 17 (13%) in the control group (odds ratio [OR] 0.7; 95% CI 0.3-1.5). Appendectomy preceded the diagnosis of microscopic colitis in 39 subjects (30%) compared with 28 (22%) in the control group (OR 1.6; 95% CI 0.9-2.7). Similar results were obtained when the analysis was restricted to microscopic colitis subtype (lymphocytic colitis or collagenous colitis).


CONCLUSIONS
In this population-based nested case-control study, no significant association was seen between cholecystectomy or appendectomy and the development of microscopic colitis or its subtypes.
Laing
Aran W
AW
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Pardi
Darrell S
DS
Loftus
Edward V
EV
Smyrk
Thomas C
TC
Kammer
Patricia P
PP
Tremaine
William J
WJ
Schleck
Cathy D
CD
Harmsen
W Scott
WS
Zinsmeister
Alan R
AR
Melton
L Joseph
LJ
Sandborn
William J
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects*; D016022:Case-Control Studies; D002763:Cholecystectomy / Q000009:adverse effects*; D046728:Colitis, Microscopic / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors