This commissioned review article was subject to full peer-review.
Review article: microscopic colitis – lymphocytic, collagenous and ‘mast cell’ colitis
Article first published online: 4 MAY 2011
© 2011 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 34, Issue 1, pages 21–32, July 2011
How to Cite
Yen, E. F. and Pardi, D. S. (2011), Review article: microscopic colitis – lymphocytic, collagenous and ‘mast cell’ colitis. Alimentary Pharmacology & Therapeutics, 34: 21–32. doi: 10.1111/j.1365-2036.2011.04686.x
- Issue published online: 2 JUN 2011
- Article first published online: 4 MAY 2011
- Publication data Submitted 30 August 2010 First decision 30 September 2010 Resubmitted 14 April 2011 Accepted 15 April 2011 EV Pub Online 4 May 2011
Aliment Pharmacol Ther 2011; 34: 21–32
Background Microscopic colitis is a relatively common cause of chronic diarrhoea in predominantly older adults, traditionally termed lymphocytic colitis and collagenous colitis. Increased mast cells found in the colonic biopsies of some patients with chronic diarrhoea may represent a distinct type of microscopic colitis.
Aim To provide an updated review of the epidemiology, diagnosis and treatment of microscopic colitis, and to discuss the role of mast cells in the gastrointestinal tract and their potential role in cases of functional diarrhoea.
Method A MEDLINE literature search was performed to identify pertinent articles. Relevant clinical abstracts were also reviewed.
Results Incidence rates of microscopic colitis (lymphocytic and collagenous colitis) have increased over time, to levels comparable with other forms of inflammatory bowel disease. The possibility of drug-induced microscopic colitis and concomitant coeliac sprue are important considerations when evaluating these patients. There are few controlled treatment trials in microscopic colitis, with much of the data on treatment coming from retrospective studies. Mast cells have been implicated in functional bowel disorders, with increased mast cells possibly contributing to cases of otherwise unexplained chronic diarrhoea, although this concept requires further investigation.
Conclusions In patients with microscopic colitis, a systematic approach to therapy often leads to satisfactory control of symptoms. The role of mast cells in chronic diarrhoea represents an evolving field, with the potential to offer alternative treatment pathways in patients with otherwise unexplained functional diarrhoea.