title: Low prevalence of 'classical' microscopic colitis but evidence of microscopic inflammation in Asian irritable bowel syndrome patients with diarrhoea.
abstract: BACKGROUND
  There is increasing evidence for the role of microscopic inflammation in patients with IBS. We aimed to examine the prevalence of microscopic colitis and inflammation in Malaysian IBS patients with diarrhoea (IBS-D).
  
  
  METHODS
  Consecutive patients who met the Rome III criteria for IBS-D and asymptomatic controls were prospectively recruited. Colonoscopy was performed in all study subjects and systematic biopsies taken from all segments of the colon. The diagnosis of lymphocytic colitis and collagenous colitis was made using previously defined criteria. Patients with post infectious IBS were excluded.
  
  
  RESULTS
  120 subjects (74 IBS-D, 46 controls) were recruited during the study period. In the IBS-D group, the colonoscopic (macroscopic) findings were as follows; normal findings n = 58 (78.4%), diverticula disease n = 5 (6.8%), diminutive polyps n = 9 (12.2%) and haemorrhoids n = 2(2.7%). No subject under the age of 40 had any significant findings. Microscopically, there was only one case (1.3%) with histology consistent with collagenous colitis. However, the IBS-D patients had a higher prevalence of moderate microscopic inflammation (n = 11, 14.9%) compared to controls (n = 1, 2.2%) (p = 0.005).
  
  
  CONCLUSIONS
  'Classical' microscopic colitis is uncommon in Malaysian patients with IBS-D but a significant number of adults showed evidence of microscopic inflammation.
authors: Gastroenterology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. ida.hilmi@gmail.com
authors: Ida
authors: I
authors: Hilmi
authors: Juanda Leo
authors: JL
authors: Hartono
authors: Jayalakshmi
authors: J
authors: Pailoor
authors: Sanjiv
authors: S
authors: Mahadeva
authors: Khean-Lee
authors: KL
authors: Goh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D016022:Case-Control Studies; D046729:Colitis, Collagenous / Q000150:complications / Q000473:pathology*; D046730:Colitis, Lymphocytic / Q000150:complications / Q000473:pathology*; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D003967:Diarrhea / Q000209:etiology; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D055815:Young Adult
references: Gastroenterology. 2004 Mar;126(3):693-702
references: 14988823
references: Gut. 2003 Apr;52(4):523-6
references: 12631663
references: Arq Gastroenterol. 2011 Jan-Mar;48(1):36-40
references: 21537540
references: J Neurogastroenterol Motil. 2011 Oct;17(4):349-59
references: 22148103
references: Curr Opin Gastroenterol. 2006 Jan;22(1):13-7
references: 16319671
references: Intern Med J. 2006 Nov;36(11):724-8
references: 17040359
references: Scand J Gastroenterol. 2012 Jun;47(6):619-24
references: 22486731
references: World J Gastrointest Pathophysiol. 2010 Aug 15;1(3):97-105
references: 21607147
references: World J Gastroenterol. 2011 Apr 21;17(15):1996-2002
references: 21528078
references: Gut. 2002 Jul;51 Suppl 1:i41-4
references: 12077063
references: Gastroenterology. 2002 Jan;122(1):20-5
references: 11781276
references: Aliment Pharmacol Ther. 2009 Aug;30(3):245-52
references: 19438846
references: J Gastroenterol. 2011 Apr;46(4):421-31
references: 21331765
references: Aliment Pharmacol Ther. 2004 Mar 15;19(6):704-6
references: 15023175
references: Inflamm Bowel Dis. 2007 Feb;13(2):175-81
references: 17206699
references: Gastroenterology. 2002 Jun;122(7):1778-83
references: 12055584
references: Gastroenterology. 2007 Mar;132(3):913-20
references: 17383420
references: Aliment Pharmacol Ther. 2004 Jul;20 Suppl 2:1-9
references: 15335408
references: Gastroenterology. 2006 Apr;130(5):1480-91
references: 16678561
references: Dig Liver Dis. 2009 Dec;41(12):844-9
references: 19716778
references: Hum Pathol. 1989 Jan;20(1):18-28
references: 2912870
references: World J Gastroenterol. 2005 Nov 7;11(41):6409
references: 16425407
references: Aliment Pharmacol Ther. 2011 Jul;34(2):259-60
references: 21679211
references: Clin Exp Gastroenterol. 2011;4:141-53
references: 21753896
references: J Gastroenterol Hepatol. 2003 Dec;18(12):1412-6
references: 14675271
references: Gastroenterol Hepatol. 2009 May;32(5):364-72
references: 19442413
references: Gastroenterology. 2002 Oct;123(4):978-84
references: 12360457
references: Gastroenterology. 2008 Nov;135(5):1510-6
references: 18926826
references: Am J Gastroenterol. 2010 Apr;105(4):859-65
references: 20179696
references: Gastroenterology. 2009 Jun;136(7):2092-100
references: 19303012
references: J Neurogastroenterol Motil. 2010 Jan;16(1):30-4
references: 20535323
references: Chin J Dig Dis. 2005;6(3):122-32
references: 16045602
references: Dig Liver Dis. 2009 Nov;41(11):772-80
references: 19665952
references: Rev Gastroenterol Mex. 2011 Jan-Mar;76(1):39-45
references: 21592902
references: Gastroenterology. 2011 Apr;140(4):1155-65
references: 21303675
references: Trop Gastroenterol. 2007 Jul-Sep;28(3):121-5
references: 18384001