Prevalence of Microscopic Colitis in Diarrhea-predominant Irittable Bowel Syndrome Patients: Cohort Study From Upper Egypt

J Clin Gastroenterol. 2022 Mar 1;56(3):e232-e238. doi: 10.1097/MCG.0000000000001592.

Abstract

Background and aim: There is controversy about colonoscopy and taking biopsy from the normal colonic mucosa in patients with a clinical diagnosis of diarrhea-predominant irritable bowel syndrome (D-IBS). This study aims to estimate the prevalence of microscopic colitis (MC) in D-IBS patients and to select patients without the well-known alarming features who will benefit from colonoscopy and biopsies from the normal colonic mucosa.

Patients and methods: We performed a cohort cross-sectional study over 6 months duration in a total of 129 patients with Rome III criteria of D-IBS after excluding cases with features of organic diseases. Cases were subjected to colonoscopy and biopsies from the colonic mucosa that seemed normal.

Results: Histopathologic examination of biopsies taken from cases with normal colonic mucosa revealed 86 (71.66%) cases with nonspecific colitis, 26 (21.66%) cases with MC and 8 (6.66%) cases with ulcerative colitis. Concomitant immunologic diseases (P=0.00005) and triggering drugs intake (P=0.006) were significantly more common in the MC group. The mean duration of diarrhea in MC patients was significantly longer than that of nonspecific colitis and ulcerative colitis patients (P=0.0006).

Conclusions: Prevalence of MC in D-IBS patients from Upper Egypt is relatively high (21.66%). Concomitant immunologic diseases, possible triggering drugs intake, and long duration of diarrhea are significant risk factors for undiagnosed MC in D-IBS patients.

MeSH terms

  • Biopsy
  • Cohort Studies
  • Colitis, Microscopic* / diagnosis
  • Colitis, Microscopic* / epidemiology
  • Colitis, Microscopic* / pathology
  • Colonoscopy / adverse effects
  • Cross-Sectional Studies
  • Diarrhea / epidemiology
  • Diarrhea / etiology
  • Egypt / epidemiology
  • Humans
  • Irritable Bowel Syndrome* / complications
  • Irritable Bowel Syndrome* / diagnosis
  • Irritable Bowel Syndrome* / epidemiology
  • Prevalence