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Ann Gastroenterol. 2011;24(4):253-262.

Recent advances in diagnosis and treatment of microscopic colitis.

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Department of Medicine, Division of Gastroenterology, Örebro University Hospital and School of Health and Medical Sciences,Örebro University, Örebro, Sweden (Curt Tysk, Anna Wickbom, Nils Nyhlin, Johan Bohr).
Department of LaboratoryMedicine, Division of Pathology, Örebro University Hospital,Örebro, Sweden (Sune Eriksson).


Microscopic colitis, comprising collagenous colitis and lymphocytic colitis, is a common cause of chronic diarrhea. It is characterized clinically by chronic watery diarrhea and a macroscopically normal colonic mucosa where diagnostic histopathological features are seen on microscopic examination. The annual incidence of each disorder is 4-6/100,000 inhabitants, with a peak incidence in individuals 60-70 years old and a noticeable female predominance in collagenous colitis. The etiology is unknown. Chronic diarrhea, abdominal pain, weight loss, fatigue, and fecal incontinence are common symptoms that impair the health-related quality of life of the patient. There is an association with other autoimmune disorders, such as celiac disease, thyroid disorders, diabetes mellitus, and arthritis. Budesonide is the best-documented treatment, both short-term and long-term. Recurrence of symptoms is common after withdrawal of successful budesonide therapy, and the optimal long-term treatment strategy needs further study. The long-term prognosis is good, and the risk of complications including colon cancer is low. We review the epidemiology, clinical features, diagnosis and treatment of microscopic colitis.


Microscopic colitis; budesonide; chronic diarrhea; collagenous colitis; lymphocytic colitis

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