Diagnosis and Management of Microscopic Colitis: Experience of a Tunisian Center

Aims Microscopic colitis(MC),which is comprised of lymphocytic colitis and collagenous colitis,is a clinicopathological diagnosis that is commonly encountered in clinical practice during the evaluation and management of chronic diarrhea.It is currently recognized as a relatively common cause of diarrhea that is as common as inflammatory bowel disease.

The purpose of this work is to report the epidemiological, clinical, therapeutic, and evolutionary aspects of microscopic colitis in our department.

Methods We conducted a retrospective observation study which had included all MC patients between January 2012 and August2017. Data collection was performed from patients’ medical records. The diagnosis of cm is retained in the presence of histological lesions, characterized by an increase of intraepithelial lymphocytes in cases of lymphocytic colitis, and a thickening of the subepithelial collagen band in case of collagen colitis.

Results The total number of patients involved in this study was12. The mean age was43years [24to73years]. The sex ratio was 0.33. There were 3c ases of collagen colitis (25 %) and 9 cases of lymphocytic colitis (75 %). Diarrhea was present in all patients, while abdominal pain (66 %) and weight loss (66 %) were frequently reported. The mean time interval from onset of symptoms to definitive cm diagnosis was 13 months [1to48months]. Biology revealed a biological inflammatory syndrome in 2 patients, anemia in 3 patients and hypoalbuminemia in one patient. 3 patients were taking a variety of medications that appeared to be associated with MC (proton pump inhibitors in 2 patients and aspirin in one patient). An associated autoimmune disease was found in 2 patients (diabetes mellitus and hypothyroidism n = 1, celiac disease (n = 1). Four patients did not receive treatments due to spontaneous disappearance of diarrhea. Treatment with salicylates was prescribed in the remaining 8 patients.The failure of salicylates was observed in 50 % of patients and led us to switch to oral corticosteroids in 3 patients and budesonide in one patient. During follow-up, recurrence of symptoms was observed in 20 % of patients after stopping induction therapy, with an average delay of 18 months.

Conclusions MC is a benign pathology whose treatment takes into account the severity of the symptoms and its impact on the quality of life of patients.That is why third of our patients were not treated.

Citation: Harbi R, Hammami A, Ben Ameur W etal. eP262 DIAGNOSIS AND MANAGEMENT OF MICROSCOPIC COLITIS: EXPERIENCE OF A TUNISIAN CENTER. Endoscopy 2021; 53: S183.

Publication History

Article published online:
19 March 2021