Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The diagnosis of microscopic colitis is made by performing biopsies from
different regions of the colon during colonoscopy or sigmoidoscopy.
The abnormalities of the colon's lining in microscopic
colitis occur in a patchy distribution (areas of normal lining may coexist
adjacent to areas of abnormal lining). For this reason, multiple biopsies should
be taken from several different regions of the colon in order to accurately make
a diagnosis.
The patchy nature of microscopic colitis also is the reason why
flexible sigmoidoscopy often is inadequate in diagnosing the condition because
the abnormalities of microscopic colitis may be absent from the sigmoid colon
(the colonic segment that is closest to the rectum and is within the reach of a
sigmoidoscope) in 30% to 40% of the patients with microscopic
colitis.
Thus, biopsies of other regions of the colon accessible only with
colonoscopy may be necessary for diagnosing microscopic colitis.
What is the treatment for microscopic colitis?
The treatment of microscopic colitis has not been standardized because there
have not been adequate large scale,
prospective, placebo controlled treatment
trials. The following strategies are safe and may relieve diarrhea in some
patients:
5-ASA (mesalamine) compounds such as Asacol, Pentasa, or Colazal
Controlled trials showed that budesonide
(Entocort, a poorly absorbed steroid) is effective in controlling diarrhea in
more than 75% of the patients with collagenous colitis, but the diarrhea tends
to recur soon after
stopping Entocort.
Though data supporting their use is lacking, some doctors may use
medications that potently suppress the immune system such as azathioprine
(Imuran, Azasan) and 6-mercaptopurine
in patients with severe microscopic colitis that is unresponsive to other
treatments.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
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