Microscopic Colitis

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What Is Microscopic Colitis? Microscopic colitis is a medical condition that causes the colon to be swollen and irritated resulting in chronic non-bloody watery diarrhea. Types Of Microscopic Colitis There are two types of microscopic colitis: Lymphocytic colitis, which results in the formation of lymphocytes on the colon tissue. Collagenous colitis, which results in the […] Read More

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Microscopic Colitis

What is Microscopic Colitis? 

Microscopic colitis is a medical condition that causes the colon to be swollen and irritated, resulting in chronic non-bloody watery diarrhea. It is an inflammation of the large intestine (colon).

Microscopic Colitis
Picture Courtesy: disease.org


types of Microscopic Colitis
Picture Courtesy: gastrosurgery

There are three types:

  • Lymphocytic colitis, which results in the formation of lymphocytes (an increase of white blood cells) on the colon tissue.
  • Collagenous colitis leads to the development of a thick layer of collagen (protein) on the colon tissue.
  • Incomplete colitis, which results in mixed features of collagenous and lymphocytic colitis.


If left untreated, microscopic colitis can lead to severe complications, which may include: 

  • Dehydration
  • Malabsorption of food nutrients
  • Malnutrition
  • Weight loss 


Colonoscopy Microscopic Colitis diagnosis
Sigmoidoscopy Microscopic Colitis diagnosis
Picture Courtesy: mayoclinic

A gastroenterologist usually diagnoses microscopic colitis. The test that is most often used to make a definitive diagnosis of microscopic colitis is a colonoscopy with a biopsy. The doctor may carry out other tests, including

  • Blood tests – To look for signs of infection and anemia.
  • Flexible Sigmoidoscopy – This procedure allows the doctor to examine the rectum and major part of the sigmoid colon (about 61cms of the large intestine). 
  • Upper endoscopy with biopsy – Helps to rule out celiac diseases. 
  • Lab tests
  • Stool tests – Helps to rule out infection as the cause of persistent diarrhea.
  • Imaging tests.


Microscopic Colitis treatment
Picture Courtesy: researchgate

Microscopic colitis may improve by itself. However, the majority of patients experience persistent symptoms. If symptoms persist, experts suggest these steps:

  • Avoid certain foods, such as caffeine or artificial sugars.
  • Take low fat and low fiber diet.
  • Stop taking medication that could trigger symptoms.
  • Discontinue dairy products, gluten, and both.
  • Medications advised for treatment are: anti-diarrheal medications (loperamide or bismuth subsalicyclate), medications that block bile acids (Colestid, prevalite, cholestyramine), anti-inflammatory drugs (mesalamine to help control inflammation of the colon), TNF inhibitors (infliximab, adalimumab, they can reduce the inflammation by neutralizing the immune system protein, i.e., Tumor necrosis factor)
  • Surgery – Surgery is rarely recommended for this disease. The doctor advises surgery only when the symptoms don’t subside with medications. During this procedure, a portion or all parts of the colon is removed.


symptoms of microscopic colitis
Picture Courtesy: epainassist

The main symptom is non-bloody diarrhea, which may persist for some time. Other symptoms include:

  • Weight loss
  • Pain and cramping in the abdomen
  • Fecal incontinence 
  • Chronic watery diarrhea
  • Nausea
  • Dehydration 

Causes of Microscopic colitis

It may have several different causes, including the following:

  • Smoking
  • Bacterial and viral Infections
  • Medications that can irritate the lining of the intestine
  • Bile acid
  • Certain autoimmune diseases

It can be hereditary in some cases. Also, some medications, such as nonsteroidal anti-inflammatory drugs and certain drugs for treating cancer or heart disease, can cause microscopic colitis.


What is Microscopic Colitis?

It refers to inflammation in the colon. There are three main types: collagenous, lymphocytic, and mixed.

What are the symptoms of microscopic colitis?

Symptoms and signs may include:
a) Watery bloodless diarrhea
b) Abdominal bloating and discomfort
c) Fatigue
d) Bowel incontinence
e) Abdominal cramps
f) Nausea

Can my diet affect my microscopic colitis?

If the symptoms are aggressive and continue without improvement, some dietary changes may be made, and substances that irritate the colon must be avoided. Some substances and foods that may irritate the colon include:
a) Caffeine
b) Lactose
c) Artificial sweeteners
d) beans
e) nuts
f) raw vegetables

Diet for microscopic colitis
Picture Courtesy: diet Vs disease

Also, it is essential to stay hydrated and eat soft foods as they are easy to digest. Some examples include:
1) Bananas
2) Rice
3) Melons
Patients are often advised to eat frequent intervals of small meals throughout the day rather than three large meals.

Is there a cure for microscopic colitis? 

There is no known cure for microscopic colitis, but dietary changes and medical treatment, including drugs, can manage the symptoms in most cases. Treatment options will depend upon the intensity of symptoms but could include:
1) Watchful waiting 
2) Dietary changes 
3) Switching medicines 
4) Anti-diarrhea medication

What are the risk factors for Microscopic Colitis?

The significant risk factors are listed below:
1) Age – usually affects older age people between 50 to 70
2) Gender – incidence is high in females compared to males.
3) Autoimmune diseases – people suffering from autoimmune disorders such as celiac disease, thyroid diseases, rheumatoid arthritis, type 1 diabetes, etc., have increased chances of developing microscopic colitis.
4) Hereditary
5) Smoking

How long does the Microscopic Colitis last?

The time frame of the illness differs from one person to another. It can typically last for days to weeks. The condition can be controlled by maintaining a healthy lifestyle and diet plan.

Can Microscopic Colitis increase the risk of cancer?

Microscopic colitis is an inflammation of the colon (large intestine). The association between it and cancer risk is unclear [1]. However, in most cases, it is seen that the condition was not associated with an increased risk of colorectal cancer and extracolonic cancer when compared to controls undergoing colonoscopy [2].

Is Microscopic Colitis an inflammatory bowel disease?

Yes, microscopic colitis is a type of inflammatory bowel disease where the inflammation of the colon is noted.


  1. https://academic.oup.com/ecco-jcc/article/15/2/212/5876409 
  2. https://www.researchgate.net/publication/330174359_Cancer_risk_in_microscopic_colitis_A_retrospective_cohort_study