Microscopic colitis: Current status, present and future challenges

Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis

“…The only life style factor measured that affected whether the patient fulfilled IBS criteria or not was smoking, which increased the risk for also suffering from IBS-like symptoms (OR = 2.68, 95% CI = 1.115- Microscopic colitis is considered to be a disease characterized by watery diarrhoea of autoimmune aetiology, and treatment of the diarrhoea by corticosteroids is the gold standard in the handling of these patients when the symptoms are relapsing [2,5].…”

“…Smoking has been described as a risk factor for developing MC [5,15]. Smoking has also been described as a risk factor for developing post-infectious functional gastrointestinal disorders (FGID) [27], and for overlapping syndromes between reflux diseases and FGID [28].…”

“…Some studies have shown a female predominance in both CC and LC [2], mainly affecting middle-aged women, whereas others have not been able to confirm this in LC [3,4]. The aetiology to MC is unknown, but autoimmunity, inflammation and bile acid malabsorption have been suggested [2,5]. It is described that MC impairs health-related quality of life (HRQOL) [6].…”

“…Corticosteroid treatment is considered the gold standard as treatment of MC, and is the drug most frequently prescribed [2,5]. As more than half of the patients suffer from abdominal pain in addition to MC, treatment with sole corticosteroids should not be enough [8].…”

Th1 Pathway: The Missing Link Between Inflammatory Bowel Disease and Microscopic Colitis?

“…In an extensive retrospective study of all diagnosed cases of MC over a 14-year period in a Canadian city, they found 2324 patients diagnosed with MC and, from those, *15% with proven histological outcome were classified into four groups: ''good responders'' for those with proven histological remission after treatment, ''poor responders,'' with persistent histological lesions after medical treatment, ''IBD-regressors,'' patients with a previous history of IBD and a subsequent diagnosis of MC, and ''IBD-progressors'' for those who were diagnosed with IBD after the first MC diagnosis. As regards the ''good'' and ''poor'' responder groups, only histological criteria were taken into account, despite current guidelines that state that the primary goal in active MC is to achieve clinical remission, as the usefulness of monitoring histological mucosal remission is currently unknown [5].…”