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Microscopic Colitis: The Less Common Inflammatory Bowel Disease

Aug 02, 2022

Microscopic colitis is an inflammatory condition of the colon that can cause chronic, watery diarrhea. It is less common than the other inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis.

Microscopic colitis is an inflammatory condition of the colon that can cause chronic, watery diarrhea. It is less common than the other inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. Females and middle age adults (45 years and older) are more likely to get microscopic colitis.

Symptoms of microscopic colitis

The most common symptom is diarrhea. You may also experience a strong urge to have a bowel movement (need a bathroom right away), stool incontinence, abdominal pain and/or weight loss.

Diarrhea is defined as stool that has decreased consistency, increased liquidity, and usually occurs more than 3 times per day. Acute diarrhea usually lasts less than 2 weeks even though it may take 3-4 weeks for your bowels to return to normal. Chronic diarrhea lasts longer than 4 weeks

When to see a doctor for diarrhea

You should see your doctor if you are experiencing diarrhea that lasts longer than 2 weeks. There are many different causes for chronic diarrhea including other forms of colitis, irritable bowel syndrome, overflow diarrhea from constipation, medications, malabsorption syndrome, or malignancy. A medical evaluation is needed to determine the exact cause.

Please note that you should see a doctor sooner if the diarrhea is accompanied by rectal bleeding, rectal pain, severe abdominal pain, high fever or signs of dehydration. Always talk with your doctor if you are concerned about your symptoms.

Diagnosis of microscopic colitis

First steps to determine the cause of diarrhea usually include blood tests and stool analysis. If those do not provide any answers and if symptoms persist, a colonoscopy is required to directly visualize the colon and take biopsies. The colon usually appears normal with microscopic colitis. However, the biopsies will reveal if there is any microscopic inflammation present (hence the name microscopic colitis).

Treatment of microscopic colitis

The goal of treatment is to improve your quality of life and get the diarrhea under control. A common medication used is budesonide that helps decrease the inflammation in your colon. Anti-diarrheal medication can also be used to decrease the amount of stools per day.

Your doctor will review the medications you are currently taking. There are some medications associated with microscopic colitis including NSAIDs (nonsteroidal anti-inflammatory drugs), aspirin, antacids and antidepressants.

Living with microscopic colitis

While microscopic colitis is non-progressive, it is a relapsing and remitting disease. This means that you may have periods of time with no symptoms, followed by a recurrence of symptoms. Here are some tips that may help reduce symptoms:

  1. If you smoke, we recommend that you stop smoking. See these tips to help you quit.
  2. Dietary changes: There is no specific diet for microscopic colitis. However, some people find improvement in symptoms if they avoid excess sugar and caffeine, limit dairy and fatty foods and follow a low fiber diet.
  3. Avoid NSAIDs (nonsteroidal anti-inflammatory drugs) and talk with your doctor to determine if any other medications should be discontinued.

If you are experiencing chronic diarrhea, contact Richmond Gastroenterology to schedule an appointment.

Disclaimer: This blog article is intended to be informative and is not medical advice.