New insights and challenges in microscopic colitis
(2015) In Therapeutic Advances in Gastroenterology 8(1). p.37-47- Abstract
- Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with... (More)
- Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with the intestinal lumen. Furthermore, some patients with a microscopic inflammation in their colonic mucosa have no symptoms, or are suffering from constipation or abdominal pain, rather than diarrhea. Recently, a discussion was initiated calling into question the overdiagnosing of symptoms and pointing out the danger of exacerbating people's perception of their ailments, of weakening their eligibility in health insurance, of overprescription of drugs, and thus the increasing cost to the society of health care. In the light of this discussion, this review will highlight histopathological and clinical features of MC, and discuss the diagnosis and management of this disease. Perhaps, the intestinal mucosa has no other mode by which to react than an inflammatory response, irrespective of the presence or absence of autoimmunity. Thus, to better identify and classify subgroups of MC, and to clarify and correctly handle the inflammatory changes, this field of research stands to benefit from a review of the results and experience gained to date. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4941626
- author
- Ohlsson, Bodil LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ageing, irritable bowel syndrome, lifestyle factors, microscopic, colitis, smoking
- in
- Therapeutic Advances in Gastroenterology
- volume
- 8
- issue
- 1
- pages
- 37 - 47
- publisher
- SAGE Publications
- external identifiers
-
- wos:000346580300003
- pmid:25553078
- scopus:84919469266
- pmid:25553078
- ISSN
- 1756-283X
- DOI
- 10.1177/1756283X14550134
- language
- English
- LU publication?
- yes
- id
- d639819f-0f17-4937-bb51-7753d6542352 (old id 4941626)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/25553078?dopt=Abstract
- date added to LUP
- 2016-04-01 10:27:37
- date last changed
- 2022-03-04 19:47:21
@article{d639819f-0f17-4937-bb51-7753d6542352,
abstract = {{Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with the intestinal lumen. Furthermore, some patients with a microscopic inflammation in their colonic mucosa have no symptoms, or are suffering from constipation or abdominal pain, rather than diarrhea. Recently, a discussion was initiated calling into question the overdiagnosing of symptoms and pointing out the danger of exacerbating people's perception of their ailments, of weakening their eligibility in health insurance, of overprescription of drugs, and thus the increasing cost to the society of health care. In the light of this discussion, this review will highlight histopathological and clinical features of MC, and discuss the diagnosis and management of this disease. Perhaps, the intestinal mucosa has no other mode by which to react than an inflammatory response, irrespective of the presence or absence of autoimmunity. Thus, to better identify and classify subgroups of MC, and to clarify and correctly handle the inflammatory changes, this field of research stands to benefit from a review of the results and experience gained to date.}},
author = {{Ohlsson, Bodil}},
issn = {{1756-283X}},
keywords = {{ageing; irritable bowel syndrome; lifestyle factors; microscopic; colitis; smoking}},
language = {{eng}},
number = {{1}},
pages = {{37--47}},
publisher = {{SAGE Publications}},
series = {{Therapeutic Advances in Gastroenterology}},
title = {{New insights and challenges in microscopic colitis}},
url = {{http://dx.doi.org/10.1177/1756283X14550134}},
doi = {{10.1177/1756283X14550134}},
volume = {{8}},
year = {{2015}},
}