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Microscopic Colitis

Salmaan A. Jawaid, MD and Christopher A. Marshall, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Microscopic colitis (MC) is a relatively common cause of chronic, recurrent nonbloody diarrhea with two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC). MC is typical...

DIAGNOSIS

HISTORY

  • Typically chronic or intermittent nonbloody diarrhea in older individuals with risk factors (MC can present in young patients.)

  • Diarrhea can result in significant electrolyte abnormali...

TREATMENT

GENERAL MEASURES

  • Discontinue potentially causative medications.

  • Smoking cessation

MEDICATION

First Line

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

High incidence of recurrence (30–80%) is common after cessation of budesonide. In these patients, daily budesonide (6 mg/day) can be used. Once remission is reach...

REFERENCES

1
Pardi DS, Kelly CP. Microscopic colitis. Gastroenterology.  2011;140(4):1155–1165. [View Abstract on OvidMedline]
2
Park T, Cave D, Marshall C. Microscopic colitis: a review of etiology...

ADDITIONAL READING

Boland K, Nguyen GC. Microscopic colitis: a review of collagenous and lymphocytic colitis. Gastroenterol Hepatol (N Y).  2017;13(11):671–677 [View Abstract on OvidMedline]

CODES

ICD10

  • K52.839 Microscopic colitis, unspecified

  • K52.838 Other microscopic colitis

ICD9

558.9 Other and unspecified noninfectious gastroenteritis and colitis 

CLINICAL PEARLS

  • MC is high on the differential for patients with chronic nonbloody diarrhea.

  • Colonoscopy with biopsies are required to make a definitive diagnosis of MC.

  • Identify and stop any potentiall...

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