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Microscopic Colitis – Triggers, Dietary Considerations, and Symptoms

Microscopic Colitis:

Triggers, Dietary Considerations, and Symptoms

Jan 05, 2024


Microscopic colitis refers to a chronic inflammatory bowel disease characterized by inflammation of the colon, particularly in the microscopic layers of the colon lining. There are two main subtypes of microscopic colitis: collagenous colitis and lymphocytic colitis. Despite having similar symptoms, the two subtypes differ in terms of specific histological features observed under a microscope.


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1. Collagenous Colitis:

In collagenous colitis, a characteristic feature is the presence of a thickened band of collagen, a fibrous protein, in the connective tissue beneath the colon lining.

This thickening can lead to inflammation and damage in the colon, resulting in symptoms such as chronic, watery diarrhea, abdominal pain, and weight loss.

2. Lymphocytic Colitis:

Lymphocytic colitis is characterized by an increased number of lymphocytes, a type of white blood cell, in the epithelium of the colon lining.

Similar to collagenous colitis, lymphocytic colitis presents with symptoms like chronic diarrhea, abdominal pain, and weight loss.

Common Features:

Both subtypes of microscopic colitis typically present with chronic, non-bloody diarrhea as a predominant symptom.

Microscopic colitis is often diagnosed through the examination of biopsies taken during colonoscopy, where the characteristic histological features are observed under a microscope.

Triggers of Microscopic Colitis:

Microscopic colitis has multifaceted triggers, encompassing both genetic and environmental factors. While the precise etiology remains elusive, studies suggest a genetic predisposition, with familial clustering observed in some cases. Environmental triggers include medications such as non-steroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPIs), and selective serotonin reuptake inhibitors (SSRIs). A comprehensive understanding of these triggers is crucial for preventive strategies and tailored management approaches.

Dietary Considerations:

Emerging research underscores the potential impact of diet on microscopic colitis. Dietary factors may influence the development and exacerbation of symptoms. Notably, a gluten-free diet has shown promise in alleviating symptoms in some individuals. Furthermore, certain artificial sweeteners and food additives have been implicated as potential triggers. The intricate interplay between diet and microscopic colitis necessitates further exploration of targeted dietary interventions.

Symptoms of Microscopic Colitis:

Microscopic colitis presents a spectrum of symptoms, and a nuanced understanding is vital for accurate diagnosis and effective management. Common symptoms include chronic, watery diarrhea, abdominal pain, and weight loss. Fatigue, anemia, and dehydration may also ensue. Distinguishing these symptoms from other gastrointestinal conditions is crucial for timely intervention. Insights from the NHS and scholarly articles contribute to a comprehensive understanding of the diverse symptomatology associated with microscopic colitis.

Our Mission

Microscopic colitis poses a unique set of challenges, necessitating an integrative approach to diagnosis and management. Genetic predisposition, environmental triggers, dietary influences, and a diverse array of symptoms underscore the complexity of this condition. Collaborative efforts between healthcare professionals, researchers, and patients are essential for advancing our understanding and improving outcomes for individuals affected by microscopic colitis. As ongoing research continues to unravel the intricacies of this condition, a patient-centered approach remains paramount for optimal care and enhanced quality of life.

Frequently Asked Questions:

1. What Treatment Options are Available?

Treatment may include medications like budesonide, dietary modifications, avoiding trigger medications, and managing associated symptoms such as diarrhea and dehydration.

2. Is Diet Important in Managing Microscopic Colitis?

Yes, dietary adjustments, such as adopting a gluten-free diet, may be beneficial. Identifying and avoiding trigger foods can also help manage symptoms.

3. Can Microscopic Colitis Lead to Other Complications?

While not common, untreated or severe cases may lead to complications such as dehydration, electrolyte imbalances, or malnutrition.

4. Is Microscopic Colitis Associated with Increased Cancer Risk?

No, microscopic colitis is generally not associated with an increased risk of colorectal cancer.

5. Can Stress Aggravate Microscopic Colitis?

While stress may exacerbate symptoms in some individuals, it is not considered a direct cause of microscopic colitis.

Our Mission

Recognizing signs and symptoms associated with Ulcerative Colitis is essential for early intervention and ultimately leads to enhanced health outcomes. Our mission is to heighten awareness regarding the crucial role of proactive healthcare in managing this condition effectively. It is essential to seek personalized advice and treatment plans from healthcare professionals. Take the first step towards proactive care by scheduling a telehealth appointment with us today!


1. National Health Service (NHS). (2022). Microscopic Colitis.

2. Bohr, J., Tysk, C., Eriksson, S., & Abrahamsson, H. (2009). Collagenous Colitis: A Systematic Review with Clinical Observations. Scandinavian Journal of Gastroenterology, 44(6), 714-725.

3. Münch, A., Aust, D., Bohr, J., Bonderup, O., Fernández Bañares, F., Hjortswang, H., ... & Miehlke, S. (2016). Microscopic Colitis: Current Status, Present and Future Challenges: Statements of the European Microscopic Colitis Group. Journal of Crohn's and Colitis, 10(8), 932-945.

4. Fine, K. D., Do, K., Schulte, K., & Ogunji, F. (1998). High Prevalence of Celiac Sprue-Like HLA-DQ Genes and Enteropathy in Patients with the Microscopic Colitis Syndrome. The American Journal of Gastroenterology, 93(4), 611-616.

5. Olesen, M., Eriksson, S., Bohr, J., Järnerot, G., & Tysk, C. (2004). Lymphocytic Colitis: A Long-Term Follow-Up Study. European Journal of Gastroenterology & Hepatology, 16(3), 289-294.

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