Microscopic Colitis
in Denver

What is Microscopic Colitis?

Microscopic colitis is inflammation of the large intestine. It is called “microscopic” because in order to identify it, colon tissue must be examined under a microscope. While it is not completely understood what causes microscopic colitis, it may be caused by a number of factors including medications, bacteria, viruses, bile acid or autoimmune disease.

There are different forms of microscopic colitis, including lymphocytic colitis, collagenous colitis and incomplete microscopic colitis.

Lymphocytic Colitis

There is an increase in lymphocytes (white blood cells) in the lining of the colon.

Collagenous Colitis

The layer of fibrous connective tissue under the lining of the colon becomes thicker.

Incomplete Microscopic Colitis

This exhibits mixed features of both lymphocytic and collagenous colitis.

The signs and symptoms of microscopic colitis may come and go frequently, and include:

• Chronic diarrhea.
• Abdominal pain or cramping.
• Nausea.
• Weight loss.
• Dehydration.

How is Microscopic Colitis Diagnosed?

If you are experiencing the symptoms associated with microscopic colitis, be sure to speak with your doctor. He or she will speak with you regarding your medical history and also ask if you are taking certain medications such as aspirin, ibuprofen or proton pump inhibitors, as this may increase your risk for developing microscopic colitis. Your doctor may also recommend you undergo some testing to best confirm a diagnosis. These tests may include a colonoscopy, flexible sigmoidoscopy, stool sample analysis or blood tests.

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Treatment Options for Microscopic Colitis

While microscopic colitis may get better on its own, treatment is available for severe or persistent symptoms. Your doctor may create a treatment plan that involves the following:

Diet Changes

Making certain changes to your daily diet may help to relieve diarrhea, and may include eating low-fat, low-fiber foods, and avoiding sugar, caffeine, dairy and gluten.

Anti-Diarrheal Medications

Over-the-counter medications to stop diarrhea such as Imodium or Pepto-Bismol can help in mild to moderate cases.

Corticosteroids

Corticosteroids such as prednisone or budesonide work by decreasing inflammation and the amount of activity of the immune system.

5-ASAs

Aminosalicylates, or 5-ASAs, work by reducing inflammation and allowing damaged tissues to heal.

Immunosuppressants

These medications work by suppressing the immune system to reduce levels of inflammation in those with microscopic colitis. Common examples include azathioprine (Imuran), methotrexate and ciclosporin, among others.

Biologics

Biologics are medications made from living organisms that work on the immune system, targeting specific proteins that cause inflammation. Common examples of biologics used to treat microscopic colitis include Adalimumab (Humira), Certolizumab (Cimzia), Ustekinumab (Stelara) and Vedolizumab (Entyvio), among others.

Surgery

In rare cases where symptoms are persistent and severe, surgery may be recommended. A procedure to remove all or part of the colon may be performed.

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