This is an automatically translated article.
Posted by Doctor Mai Vien Phuong - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital
Microscopic colitis is a chronic inflammatory condition of the colon that is characterized by the clinical presentation of chronic diarrhea but the patient has a normal colonoscopy and the diagnosis is based only on histology. pathology. Microscopic colitis is divided into two groups of collagenous colitis and lymphocytic colitis.
1. The history of this particular pathology
Collagen colitis was first described in 1976 In a patient with chronic diarrhea who underwent a biopsy of the rectal mucosa. Biopsy results showed dense collagen deposition in the subepithelial layer. In 1980, Read et al. first used the term "gastric colitis" to describe a disease characterized by chronic diarrhea and colorless stools.
Later in 1989, Lazenby et al. described the clinical and histopathological features of lymphoid colitis. These two diseases have many similarities in terms of clinical and epidemiological characteristics, so they are grouped together in the group of microscopic colitis. The difference is determined only by histopathology in that collagenous colitis is characterized by collagen deposition in the subepithelial layer and lymphocytic colitis is characterized by lymphocytic infiltration of the epithelial layer.
2. Microscopic colitis is common
According to a review and meta-analysis of 25 studies, the prevalence rates of collagenous colitis and lymphoid colitis were 49.21 (95%C; 20.95 - 77.48) and 63, respectively. .05 (95%CI: 46.63 - 79.47) per 100,000 people.
The annual incidence of collagenous colitis and lymphocytic colitis per 100,000 people annually is 4.14 (95% CI: 2.89 -5.40) and 4.85 (95% CI: 3.45, respectively. -6,25) [4].
The incidence of these two diseases varies by region, but the studies are mainly in Europe and the Americas. In the Asian region, some studies have begun, such as in Korea, which recorded the rate of collagenous colitis in patients with chronic diarrhea is 4%, similar to the rate in Western countries but higher. compared with the study of Indian and Malaysian authors.
Collagen colitis is common in middle-aged women with the most common rate being between the ages of 60 and 70. According to the study of Tong et al., the female/male ratio in real patients with collagenous colitis is 3, 05 (95% CI: 2.92 - 3.19), in patients with lymphocytic colitis 1.92 (95% CI: 1.53 - 2.31). The median age at diagnosis of these two diseases was 64.9 and 62.8, respectively. The incidence of microscopic colitis increases with age.
Before the 2000s, in Western countries, the annual incidence of microscopic colitis gradually increased, then after 2000 it started to stabilize. In developing countries, so far not much data is available.
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3. Conclusion
Both lymphocytic colitis and collagenous colitis can be classified under the common name of microscopic colitis. Clinical features include chronic, non-haemorrhagic, watery diarrhea and histological findings of lymphocyte proliferation or collagen thickening in the colonic mucosa. These diseases are thought to be of autoimmune origin and have been linked to celiac disease, thyroid disease, and diabetes. The cause is still unclear. The goal of treatment remains to eliminate aggravating factors and control symptoms.
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References:
Lina Vigren, Martin Olesen, et al. An epidemiological study of collagenous colitis in southern Sweden from 2001-2010. World J Gastroenterol. 2012 June 14; 18(22): 2821–2826. Gianluca Ianiro, Giovanni Cammarota, Luca Valerio, Brigida Eleonora Annicchiarico, Alessandro Milani, Massimo Siciliano and Antonio Gasbarrini. Microscopic colitis . World J Gastroenterol. 2012 November 21; 18(43): 6206-6215. Marina Kim, Archana Patel, Diagnosis and Management of Microscopic Colitis: A Review of the Literature, Inflammatory bowel disease: a practical approach, Series
87, Practical Gastroenterology • february 2014
