title: Chronic non-bloody diarrhoea: a prospective study in Malmö, Sweden, with focus on microscopic colitis.
abstract: BACKGROUND
  Chronic non-bloody diarrhoea affects up to 5% of the population. Microscopic colitis is one of the most common causes, encompassing the subtypes collagenous colitis and lymphocytic colitis. The diagnosis of microscopic colitis is made by histological examination of colonic mucosal biopsy specimens. The aim of this investigation was to determine whether laboratory parameters or questions about disease history or concomitant disease could be helpful in discriminating patients with MC from those with a histologically normal colonic mucosa.
  
  
  RESULTS
  Patients admitted for colonoscopy because of chronic non-bloody diarrhoea (>2 loose stools for >3 weeks) at endoscopy units in Malmö during 2007 and 2009, were enrolled. A total number of 78 patients were included (60 women, 18 men, median age 59, IQR 45-69 years). Out of these 78, 15 patients (19%) had microscopic colitis (CC; n = 10, LC; n = 5). MC was especially prevalent in patients above the age of 50 (25%). No differences were found between those with normal histology and MC in laboratory analyses (inflammatory and liver parameters). Neither were differences shown in questions regarding symptoms, environmental factors or concomitant diseases except for an association with celiac disease (p = 0.019) and a trend maybe indicating an inverse association with appendectomy (p = 0.057).
  
  
  CONCLUSIONS
  Microscopic colitis is associated with female gender, celiac disease and consumption of NSAIDs. Trends were observed indicating that age above 50 years, acute onset and absence of appendectomy may be associated with MC. No associations were observed with other symptoms, calprotectin levels or liver parameters.
authors.forename: Johanna K
authors.initials: JK
authors.lastname: Larsson
authors.affiliation: Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Skåne University Hospital, Lund University, Malmö, Sweden. klas.sjoberg@med.lu.se.
authors.forename: Klas
authors.initials: K
authors.lastname: Sjöberg
authors.forename: Lina
authors.initials: L
authors.lastname: Vigren
authors.forename: Cecilia
authors.initials: C
authors.lastname: Benoni
authors.forename: Ervin
authors.initials: E
authors.lastname: Toth
authors.forename: Martin
authors.initials: M
authors.lastname: Olesen
mesh_terms: D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001062:Appendectomy / Q000706:statistics & numerical data; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D046729:Colitis, Collagenous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D046730:Colitis, Lymphocytic / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D003106:Colon / Q000473:pathology*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D013548:Sweden
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
references.citation: Gut. 1995 Jun;36(6):880-6
references.pmid: 7615277
references.citation: Endoscopy. 1999 Oct;31(8):641-6
references.pmid: 10571138
references.citation: World J Gastroenterol. 2008 Dec 28;14(48):7280-8
references.pmid: 19109861
references.citation: Inflamm Bowel Dis. 2006 Aug;12(8):708-11
references.pmid: 16917225
references.citation: Gut. 2004 Mar;53(3):346-50
references.pmid: 14960513
references.citation: Scand J Gastroenterol. 2013 Aug;48(8):944-50
references.pmid: 23800241
references.citation: Pathol Eur. 1976;11(1):87-9
references.pmid: 934705
references.citation: Hum Pathol. 1990 Sep;21(9):905-10
references.pmid: 2394435
references.citation: Gut. 2004 Sep;53 Suppl 5:V1-16
references.pmid: 15306569
references.citation: Eur J Gastroenterol Hepatol. 2007 Jul;19(7):567-74
references.pmid: 17556903
references.citation: Gut. 2003 Jul;52 Suppl 5:v1-15
references.pmid: 12801941
references.citation: Dig Liver Dis. 2012 May;44(5):384-8
references.pmid: 22265684
references.citation: Gut. 2000 Feb;46(2):170-5
references.pmid: 10644309
references.citation: Aliment Pharmacol Ther. 2012 Jul;36(2):79-90
references.pmid: 22670660
references.citation: World J Gastroenterol. 2008 Jul 21;14(27):4319-23
references.pmid: 18666319
references.citation: Clin Chim Acta. 2000 Feb 25;292(1-2):41-54
references.pmid: 10686275
references.citation: Am J Gastroenterol. 2000 Oct;95(10):2831-7
references.pmid: 11051356
references.citation: Neth J Med. 2005 Apr;63(4):137-40
references.pmid: 15869041
references.citation: Am J Epidemiol. 1992 Jul 15;136(2):165-77
references.pmid: 1415139
references.citation: J Clin Gastroenterol. 2006 Jan;40(1):44-8
references.pmid: 16340633
references.citation: Am J Gastroenterol. 1999 Feb;94(2):418-23
references.pmid: 10022639
references.citation: Dig Dis Sci. 2006 Feb;51(2):241-4
references.pmid: 16534662