title: Microscopic colitis or functional bowel disease with diarrhea: a French prospective multicenter study.
abstract: OBJECTIVE
  To describe the characteristics of a cohort of patients with microscopic colitis (MC; lymphocytic (LC) or collagenous (CC) colitis) and to compare them with patients with functional bowel disorder with diarrhea (FBD-D).
  
  
  METHODS
  Between September 2010 and June 2012, patients fulfilling the following inclusion criteria were prospectively included in 26 centers in France: (i) having at least three bowel movements daily with change in stool consistency; (ii) duration of abnormal bowel habit >4 weeks; and (iii) normal or near-normal colonoscopy. Each patient underwent a colonoscopy and colonic biopsies. We compared the demographic, clinical, biological, and etiological characteristic of patients with MC (CC and LC) with those of control patients with FBD-D.
  
  
  RESULTS
  A total of 433 patients were included: 129 with MC (87 LC and 42 CC), 23 with another organic disease, and 278 with FDB-D, including patients with diarrhea and abdominal pain who met the criteria of Rome III (irritable bowel syndrome with diarrhea) and patients with functional diarrhea without abdominal pain. Logistic regression analysis identified the following independent predictors of MC: age >50 years (odds ratio (OR)=3.1, 95% confidence interval (CI)=1.6-5.9), presence of nocturnal stools (OR=2, 95% CI=1.1-3.9), weight loss (OR=2.5, 95% CI=1.3-4.7), duration of diarrhea <12 months (OR=2.0, 95% CI=1.1-3.5), recent introduction of new drugs (OR=3.7, 95% CI=2.1-6.6; P<0.0001), and the presence of a known autoimmune disorder (OR=5.5, 95% CI=2.5-12).
  
  
  CONCLUSIONS
  Age >50 years, the presence of nocturnal stools, weight loss, the introduction of a new drug, and the presence of a known autoimmune disease increase the probability of MC and thus the indication for colonoscopy with biopsies.
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Marne la Vallée, Jossigny, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Macaigne
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Limeil-Brévannes, Limeil-Brévannes, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lahmek
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Meaux, Meaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Locher
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lesgourgues
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Costes
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Montauban, Montauban, France.
authors.forename: Max Pierre
authors.initials: MP
authors.lastname: Nicolas
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier Intercommunal de Villeneuve Saint-Georges, Villeneuve Saint-Georges, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Courillon-Mallet
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Jolimont, Jolimont, Belgique.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Ghilain
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier Intercommunal d'Aulnay sous Bois, Aulnay sous bois, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Bellaïche
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier d'Aubagne, Aubagne, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: de Montigny-Lehnardt
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Coulommiers, Coulommiers, France.
authors.forename: Georges
authors.initials: G
authors.lastname: Barjonet
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier Intercommunal de Poissy, Poissy, France.
authors.forename: René-Louis
authors.initials: RL
authors.lastname: Vitte
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier départemental de La Roche sur Yon, La Roche sur Yon, France.
authors.forename: Roger
authors.initials: R
authors.lastname: Faroux
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier Sud Francilien, Evry, France.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Lambare
authors.affiliation: Service de Gastro-Entérologie, Centre Hospitalier de Neuilly sur Seine, Neuilly sur seine, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Fleury
authors.affiliation: 1] Service de Gastro-Entérologie, Centre Hospitalier de Pau, Pau, France [2] These authors contributed equally to this work.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pariente
authors.affiliation: 1] Service de Gastro-Entérologie, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France [2] These authors contributed equally to this work [3] Full investigators are listed before study highlights.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Nahon
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000367:Age Factors; D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications / Q000453:epidemiology; D001706:Biopsy; D016022:Case-Control Studies; D046729:Colitis, Collagenous / Q000150:complications* / Q000453:epidemiology; D046730:Colitis, Lymphocytic / Q000150:complications* / Q000453:epidemiology; D003106:Colon / Q000473:pathology; D003113:Colonoscopy; D003672:Defecation; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007008:Hypokalemia / Q000453:epidemiology; D043183:Irritable Bowel Syndrome / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D015431:Weight Loss