Systematic review: microscopic colitis
Article first published online: 27 APR 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 11, pages 1525–1534, June 2006
How to Cite
NYHLIN, N., BOHR, J., ERIKSSON, S. and TYSK, C. (2006), Systematic review: microscopic colitis. Alimentary Pharmacology & Therapeutics, 23: 1525–1534. doi: 10.1111/j.1365-2036.2006.02913.x
- Issue published online: 27 APR 2006
- Article first published online: 27 APR 2006
- Publication data Submitted 10 January 2006 First decision 13 February 2006 Resubmitted 3 March 2006 Accepted 3 March 2006
Collagenous and lymphocytic colitis are fairly common causes of chronic non-bloody diarrhoea, especially in elderly female.
To present a systematic review of microscopic colitis.
A PubMed search using the MeSH terms microscopic colitis, collagenous colitis, lymphocytic colitis and chronic diarrhoea was performed.
Annual incidence of each disorder is 4–6/100 000 inhabitants. The aetiology is unknown. Clinical characteristics are well described and there is an association with autoimmune diseases. Budesonide is the best-documented short-term treatment of collagenous colitis. In meta-analysis pooled odds ratio for clinical response after 6–8 weeks of treatment was 12.3 (95% CI: 5.5–27.5) in comparison with placebo. The evidence for bismuth subsalicylate is weaker and the effectiveness of other alternatives such as loperamide, cholestyramine, aminosalicylates, probiotics, or Boswellia serrata extract is unknown. Although unproven, in unresponsive severe disease azathioprine or methotrexate may be tried. No controlled trials have been carried out in lymphocytic colitis. The long-term prognosis of microscopic colitis is good, serious complications are rare and there is no increased mortality.
Clinical and epidemiological aspects of microscopic colitis are well described. Budesonide is the best-documented short-term therapy in collagenous colitis, but the optimal long-term strategy needs further study. Controlled treatment data of lymphocytic colitis are awaited for.