Overview of microscopic colitis

Br J Hosp Med (Lond). 2020 Oct 2;81(10):1-7. doi: 10.12968/hmed.2020.0034. Epub 2020 Oct 6.


Microscopic colitis encompasses both collagenous and lymphocytic colitis and is a relatively common condition with rising incidence. Diagnosis is by colonoscopy (which is usually normal but may show some mild changes) and biopsies which reveal characteristic histological findings. Symptoms include non-bloody diarrhoea with urgency which may be associated with faecal incontinence and abdominal pain. Microscopic colitis is associated with a reduced health-related quality of life, and treatment is aimed at symptom control. Medications linked with the development of microscopic colitis, including proton pump inhibitors, non-steroidal anti-inflammatory drugs and selective serotonin-reuptake inhibitors, should be discontinued. If symptoms persist, budesonide is a licensed treatment for microscopic colitis which has been shown to be effective in clinical trials and real-world practice.

Keywords: Budesonide; Collagenous colitis; Lymphocytic colitis; Microscopic colitis; Proton pump inhibitors.

Publication types

  • Review

MeSH terms

  • Abdominal Pain
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Budesonide / therapeutic use
  • Colitis, Microscopic* / diagnosis
  • Colitis, Microscopic* / drug therapy
  • Colitis, Microscopic* / epidemiology
  • Diarrhea / diagnosis
  • Diarrhea / drug therapy
  • Diarrhea / etiology
  • Humans
  • Proton Pump Inhibitors / therapeutic use
  • Quality of Life
  • Selective Serotonin Reuptake Inhibitors / therapeutic use


  • Anti-Inflammatory Agents, Non-Steroidal
  • Proton Pump Inhibitors
  • Serotonin Uptake Inhibitors
  • Budesonide