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Microscopic colitis

Microscopic colitis is an inflammation of the large intestine (colon) that causes persistent watery diarrhea. The disorder gets its name from the fact that it's necessary to examine colon tissue under a microscope to identify it.

There are two types of microscopic colitis:

  • Collagenous colitis, in which a thick layer of protein (collagen) develops in colon tissue
  • Lymphocytic colitis, in which white blood cells (lymphocytes) increase in colon tissue

It isn't known whether collagenous (kuh-LAYJ-uh-nus) colitis and lymphocytic colitis are two separate disorders or represent different phases of the same condition. However, symptoms of collagenous colitis and lymphocytic colitis are similar, as are testing and treatment.

The symptoms of microscopic colitis can come and go frequently. Sometimes the symptoms resolve on their own. If not, your doctor can suggest a number of effective medications.

Symptoms Causes Risk factors

Signs and symptoms of microscopic colitis include:

  • Chronic watery diarrhea
  • Abdominal pain or cramps
  • Weight loss
  • Nausea
  • Fecal incontinence

When to see a doctor

If you have watery diarrhea that lasts more than a few days, contact your doctor so that your condition can be diagnosed and properly treated.

It's not clear what causes the inflammation of the colon found in microscopic colitis. Researchers believe that the causes may include:

  • Medications that can irritate the lining of the colon
  • Bacteria that produce toxins that irritate the lining of the colon
  • Viruses that trigger inflammation
  • Immune system problems, such as rheumatoid arthritis or celiac disease, that occur when your body's immune system attacks healthy tissues

Risk factors for microscopic colitis include:

  • Age and gender. Microscopic colitis is most common in people ages 50 to 70 and more common in women than men.
  • Immune system problems. People with microscopic colitis sometimes also have an autoimmune disorder, such as celiac disease, thyroid disease or rheumatoid arthritis.
  • Smoking. Recent research studies have shown an association between tobacco smoking and microscopic colitis, especially in people ages 16 to 44.

Some research studies indicate that using certain medications may increase your risk of microscopic colitis. But not all studies agree. Medications linked to the condition include:

  • Aspirin, acetaminophen (Tylenol, others), and ibuprofen (Advil, Motrin IB, others)
  • Proton pump inhibitors, including lansoprazole
  • Acarbose (Precose)
  • Flutamide
  • Ranitidine (Zantac)
  • Selective serotonin reuptake inhibitors, such as sertraline (Zoloft)
  • Carbamazepine

It's not clear why some people who use these medications develop microscopic colitis while others don't.

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