Microscopic colitis is an inflammation in the large intestine (colon) that often causes persistent, watery diarrhea and other gastrointestinal symptoms. Doctors need a microscope to identify microscopic colitis, hence the name. The condition will not present during a colonoscopy or flexible sigmoidoscopy. People with microscopic colitis often experience everyday symptoms.
There are a few different variations of microscopic colitis:
Each type of microscopic colitis presents similar symptoms and requires the same testing and treatment. Microscopic colitis is often treatable with the help of a gastroenterologist’s diagnosis and care plan.
Like many gastrointestinal conditions, microscopic colitis does not have a clear, singular cause. Microscopic colitis does have potential triggers, which include:
Microscopic colitis causes a variety of symptoms. These symptoms persist for some people, while other people might experience symptoms that fade and recur over time. Symptoms of microscopic colitis include:
The primary symptom of microscopic colitis is persistent, watery diarrhea. Any of these symptoms, including diarrhea, could be a result of different gastrointestinal conditions. It is important to consult a doctor after experiencing abnormal gastrointestinal symptoms to figure out an appropriate care plan.
Some groups of people are more likely to contract microscopic colitis than others. Risk factors or groups for microscopic colitis include:
Some studies suggest a link between taking some types of medication and developing microscopic colitis. However, the scientific community does not have a consensus on whether this link actually exists. Medications that might increase risk of developing microscopic colitis are:
A gastroenterologist will diagnose microscopic colitis using a physical exam and a discussion of symptoms. The exam and discussion will also cover whether the patient has any pre-existing conditions that might increase risk of microscopic colitis, like an autoimmune disease. The doctor will also need a list of the patient’s medications to see if any medications the patient is taking are linked to microscopic colitis.
A microscopic colitis diagnosis might also require a series of testing. Tests that can help gastroenterologists detect microscopic colitis include:
Imaging from a flexible sigmoidoscopy and/or colonoscopy is often not enough. Intestinal tissue can present normally during these exams. True to the name, the tissue samples need a microscopic exam before a gastroenterologist can make a definite microscopic colitis diagnosis.
Doctors might use additional testing to make a microscopic colitis diagnosis, including:
Treatment for microscopic colitis is fairly straightforward. To start, doctors might recommend lifestyle changes to alleviate symptoms. See below for a list of lifestyle changes that might reduce symptoms of microscopic colitis.
If lifestyle changes are not enough to treat microscopic colitis, then a doctor will prescribe medication. Potential medications for this condition include:
A doctor might recommend surgery to remove all or part of the colon if the microscopic colitis becomes too severe and medication does not work.
Doctors might recommend certain lifestyle changes for patients with microscopic colitis. These strategies can relieve symptoms and potentially treat mild cases of microscopic colitis.
Lifestyle change recommendations should come from a gastroenterologist. Though simple changes will resolve some mild cases of microscopic colitis, people experiencing microscopic colitis should still seek the care of a medical professional.
A mild case of microscopic colitis that does not need medical attention. However, someone with symptoms that become more severe or persistent should schedule a doctor’s appointment as soon as possible.
Microscopic colitis presents gastrointestinal symptoms that could be attributed to a number of other conditions. It might feel confusing to determine when to see a doctor. Extreme gastrointestinal discomfort of any kind should prompt a visit to a medical professional. In any case, someone should see a doctor if they have watery diarrhea that lasts longer than a few days.
The outlook for people living with microscopic colitis is good. Some cases of microscopic colitis are mild and will go away without medical intervention. Many people with microscopic colitis will recover by taking prescribed medication. In very rare cases, patients will need surgery to treat microscopic colitis.