Microscopic Colitis

GENERAL INFORMATION:

What is microscopic colitis?

• Microscopic (mi-kro-SKOP-ik) colitis (ko-LI-tis) is a chronic (long-term) inflammation (swelling) of the colon (large intestine). The colon is the long tube that connects the small intestine with the anus. It absorbs water from digested foods and turns the digested food into stool (bowel movements). The colon stores the stool until it can be passed out through your anus.
  
  
• With microscopic colitis, the colon may have undergone abnormal changes or gotten damaged. This leads to chronic diarrhea (frequent loose, watery bowel movement). Caregivers may see a normal lining of the colon when examined using a special tube called a colonoscope. When tissue samples of the colon are taken and examined under a microscope, the lining shows inflammation.
  
  
• Microscopic colitis may be grouped into lymphocytic or collagenous microscopic colitis. In a lymphocytic microscopic colitis, lymphocytes are mostly seen in the linings of the colon. Lymphocytes are white blood cells that help fight infections. A collagenous microscopic colitis has many collagens (special proteins) present when examined. This usually makes the tissue layer of the colon thick. Diagnosing and treating microscopic colitis as soon as possible may relieve its symptoms and improve the quality of life.

What causes microscopic colitis? The exact cause of most microscopic colitis remains unknown. Caregivers believe that the following conditions may cause or increase your risk for having microscopic colitis:

• Age and sex: Middle-aged women have an increased risk of being affected.
  
  
• Bile malabsorption: Bile acids are increased in your body, especially in the colon area. They are found in a liquid called bile that helps digest foods and fats.
  
  
• Genetics: You are more likely to have microscopic colitis if another family member has this condition or other diseases of the colon.
  
  
• Infections: Germs, such as bacteria, may trigger an infection and swelling of the colon.
  
  
• Medicines: Certain medicines that are taken for a long time may increase your risk for microscopic colitis. These include medicines for treating pain, depression, seizures (convulsions), stomach ulcers (sores), or blood clots.
  
  
• Problems with immune system: The immune (body defense) system is the part of your body that fights infection. Having diabetes mellitus (high blood sugar), arthritis, scleroderma, or asthma may affect your body defenses.

What are the signs and symptoms of microscopic colitis? Your signs and symptoms may come and go with quiet and active periods. Over time, active periods may occur often and symptoms may be worse. Diarrhea caused by microscopic colitis may begin while you are taking certain medicines. It may look like a simple case of diarrhea where blood is usually absent in your stools. You may also have one or more of the following:

• Abdominal (stomach) pain.
  
  
• Body weakness.
  
  
• Dehydration (lose too much body fluid).
  
  
• Feeling like you need to have a bowel movement (BM) after just having one.
  
  
• Nausea (upset stomach) or vomiting (throwing up).
  
  
• Weight loss.

How is microscopic colitis diagnosed? You may have one or more of the following tests:

• Blood tests: Many different tests will be done with your blood, such as a test to see if you have an infection.
  
  
• Imaging tests:
  
  
  • Colonoscopy: A colonoscopy test looks at the part of your intestine called the colon. The colon is also called the large intestine. Your caregiver will use a tube with a light on the end to look inside your colon. The tube will be put into your anus, then into your colon. Samples may be taken from your colon and sent to a lab for tests.
    
    
  • Endoscopy: This test uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers may find problems with how your digestive tract is working. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.
    
    
  • Abdominal x-rays: Abdominal x-rays are pictures of the organs inside your abdomen. Caregivers use these pictures to look for problems such as blocked or ruptured intestines, kidney stones, or solid masses (tumors) in your organs.
  
  
• Stool exam: A sample of your stool is sent to a lab for testing. These stool tests may show what kind of bacteria (germs) is present and causing your illness. This helps caregivers know what treatment is best for you.

How is microscopic colitis treated? The treatment for microscopic colitis aims to replace lost fluids and prevent dehydration. Caregivers may need to stop or change the medicines you are presently taking. You may have one or more of the following:

• Medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Anti-diarrheals: This medicine is used if you have loose bowel movements (BMs). If you feel like having another BM after just having one, you may also use this medicine.
    
    
  • Anti-inflammatory medicines: Your caregiver may suggest that you take or use medicines such as steroids, to treat the inflammation.
    
    
  • Bile binders: These medicines bind the bile acids and prevent fats to form.
    
    
  • Immunosuppressants: These medicines may be given to slow down the immune system and decrease the swelling.
  
  
• Supportive therapy:
  
  
  • Oral rehydration therapy: This therapy aims to replace lost body fluids by letting you drink plenty of liquids. You may also drink an oral rehydration solution (ORS). An ORS has the right amounts of water, salts, and sugar you need to replace body fluids.
    
    
  • Intravenous therapy: If you are dehydrated, you may have to stay in the hospital and receive intravenous (IV) fluids. An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
    
    
  • Probiotics: These are supplements that contain good bacteria that is normally found in a person's colon.
  
  
• Surgery: Caregivers may need to do surgery if your microscopic colitis is very bad. This surgery removes the affected part and connects the remaining healthy colon.

Where can I find more information? Having microscopic colitis may make it hard for you to continue your usual activities. It may make things difficult for both you and your family. Contact the following for more information:

• National Digestive Diseases Information Clearinghouse (NDDIC)
  2 Information Way
  Bethesda, MD 20892-3570
  Phone: 1-800-8915389
  Web Address: www.digestive.niddk.nih.gov
  

• Crohn's and Colitis Foundation of America, Inc.
  386 Park Avenue S, 17th Floor
  New York, NY 10016-8004
  Phone: 1-800-932-2423
  Web Address: http://www.ccfa.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Link to this page

Printable Version

Email Page