Many people who are convinced they have the irritable bowel syndromethey may instead have another bowel disease called microscopic colitis. As you can guess from the name, it is called that because it can only be discovered when some cells of the intestine are observed under the lens of a microscope. Experts therefore discover it when they take a part of the tissue lining the intestine to make a biopsy. The problem is that the intestinal lining abnormalities are not uniform, but patchy. So for a correct diagnosis you need to take tissue flaps to biopsy from multiple areas.
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Microscopic colitis is grossly underreported
Experts speak of a 10-20% of patients with chronic diarrhea who would have microscopic colitis. One study claims that one in three patients diagnosed with irritable bowel syndrome actually has the disease.
There are two types of microscopic colitis, although some experts argue that the first is the disease at its onset, the second when we are in an advanced stage:
- the lymphocytic colitis: Happens when many lymphocytes build up on the lining of the colon
- that collagenosica: diarrhea has as its main cause the fact that there is inflammation and collagen draws water into the colon.
What are the causes?
To date, no studies have explained the exact causes that trigger microscopic colitis. The main hypothesis is that it is a autoimmune diseaseas is the case with the Crohn’s disease or with the Ulcerative colitis.
Among the known causes there could be the abuse of non-steroidal anti-inflammatory drugs, NSAIDs, which are extremely used medicines. To be clear, they are those that contain ibuprofen, naproxen or nimesulide.
What are the symptoms of microscopic colitis?
The most common manifestation is one chronic diarrhea. This situation can last even years, before reaching the diagnosis, precisely because, as we have explained, a biopsy is needed to be sure of this pathology. During the illness there may be periods in which one feels better, alternating with moments of severe malaise. Other symptoms can be cramps and pain in the abdomen area.
If the symptoms of diarrhea last longer than two weeks, you should always contact your doctor.
Are there any effective therapies?
There are no specific therapies and the doctor generally adopts the strategy of small steps, starting from the least invasive strategies.
The role of nutrition
The first step is to change your eating habits. One is recommended low-fat, low-fiber diet. In this way the diarrhea, which is the main symptom, can be relieved. You then try to stop eating dairy products and products that contain gluten, because they could make your symptoms worse. It is necessary to avoid taking caffeine and sugar and to stop any anti-inflammatory therapy, obviously under strict medical supervision.
There are drugs, but they are not specific
Always according to the protocol developed by the prestigious Mayo Clinic research centerYou can switch to some medications if your symptoms still don’t improve. Doctors at this point recommend taking antidiarrheals and steroids. Drugs capable of controlling inflammation and some immunomodulators and immunosuppressants may also be useful.
Can we operate?
In extremely rare cases, surgery may be decided to remove all areas of the lining of the intestine affected by the disease.