Contemporary methods for the diagnosis and treatment of microscopic colitis

Expert Rev Gastroenterol Hepatol. 2016;10(1):47-61. doi: 10.1586/17474124.2016.1096197. Epub 2015 Oct 15.


Microscopic colitis is a common cause of chronic diarrhea. It is characterized by non-bloody watery diarrhea with macroscopically normal colonic mucosa. Its specific histological characteristics confirm the diagnosis. Two distinct histological forms can be identified, namely, collagenous colitis and lymphocytic colitis. In collagenous colitis, a thick colonic subepithelial collagenous deposit can be observed, whereas in lymphocytic colitis, a pronounced intraepithelial lymphocytic inflammation in the absence of a thickened collagen band can be identified. Microscopic colitis occurs more frequently in elderly females and its etiology is believed to be multifactorial, although smoking and consumption of several drugs have been identified as risks factors for the development of the disease. The treatment is based on avoiding the risks factors and administration of oral budesonide.

Keywords: chronic diarrhea; collagenous colitis; histology; lymphocytic colitis; microscopic colitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Antidiarrheals / therapeutic use
  • Bismuth / therapeutic use
  • Budesonide / therapeutic use*
  • Colitis, Microscopic / diagnosis*
  • Colitis, Microscopic / drug therapy*
  • Colitis, Microscopic / epidemiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Induction Chemotherapy
  • Maintenance Chemotherapy
  • Mesalamine / therapeutic use
  • Organometallic Compounds / therapeutic use
  • Probiotics / therapeutic use
  • Risk Factors
  • Salicylates / therapeutic use
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors


  • Anti-Inflammatory Agents
  • Antidiarrheals
  • Immunosuppressive Agents
  • Organometallic Compounds
  • Salicylates
  • Tumor Necrosis Factor-alpha
  • Mesalamine
  • Budesonide
  • bismuth subsalicylate
  • Bismuth