Microscopic colitis: an unfamiliar but treatable disease.
Chronic diarrhoea is a frequent complaint in clinical practice. Microscopic colitis is the cause of this symptom in 10% of these cases and the prevalence is rising. To exclude microscopic colitis a colonoscopy with multiple biopsies of different regions of the colon is mandatory. A sigmoidoscopy alone is insufficient. Two histopathological types of microscopic colitis can be distinguished: collagenous colitis and lymphocytic colitis. Nowadays, there is sufficient evidence to recommend budesonide as the first-choice treatment. Bismuth can also be recommended, but this drug is not easily available in the Netherlands. Evidence of efficacy of other drugs is scant.
van der Wouden
E J
EJ
Department of Gastroenterology, Isala Clinics, Zwolle, the Netherlands. e.j.van.der.wouden@isala.nl
Karrenbeld
A
A
Kleibeuker
J H
JH
Dijkstra
G
G
D000328:Adult; D000863:Antacids / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001729:Bismuth / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D046729:Colitis, Collagenous / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D046730:Colitis, Lymphocytic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male
D000863:Antacids; D000893:Anti-Inflammatory Agents; D019819:Budesonide; D001729:Bismuth