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New insights and challenges in microscopic colitis

Ohlsson, Bodil LU (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)
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author
organization
publishing date
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 Inc.
external identifiers
  • wos:000346580300003
  • pmid:25553078
  • scopus:84919469266
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
2015-02-03 07:06:50
date last changed
2017-03-12 03:10:09
@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},
  keyword      = {ageing,irritable bowel syndrome,lifestyle factors,microscopic,colitis,smoking},
  language     = {eng},
  number       = {1},
  pages        = {37--47},
  publisher    = {SAGE Publications Inc.},
  series       = {Therapeutic Advances in Gastroenterology},
  title        = {New insights and challenges in microscopic colitis},
  url          = {http://dx.doi.org/10.1177/1756283X14550134},
  volume       = {8},
  year         = {2015},
}