Abstract

Background and AimsMicroscopic colitis is a common cause of chronic diarrhea, however the clinical course of this disease is poorly understood. We aimed to investigate how patients diagnosed with microscopic colitis were treated in routine clinical practice and how their symptoms compared to patients with other causes of chronic diarrhea at one year follow-up. MethodsWe conducted a case-control study of patients undergoing outpatient colonoscopy to evaluate diarrhea. The study pathologist determined whether patients were classified as microscopic colitis cases or non-microscopic colitis controls. One year after colonoscopy, we interviewed cases (n=74) and controls (n=162) about their diagnosis, medications for diarrhea, and symptom burden. ResultsAt one year follow-up after colonoscopy, 10% of microscopic colitis cases were unaware of the diagnosis, 60% had been prescribed a medication for diarrhea, 40% had fecal urgency, 32% had weight loss, and 21% had fecal incontinence. Among cases, 46% were treated with budesonide. Compared to cases, controls had worse symptoms based on the Microscopic Colitis Disease Activity Index (MCDAI) score with a median MCDAI score of 3.0 (IQR 1.9-4.2) vs 2.3 (IQR 1.4-3.2) at one year follow-up. Controls had more frequent stools, urgency, fecal incontinence, and abdominal pain. ConclusionsIn a cohort of patients with biopsy-confirmed microscopic colitis and diarrhea controls, we found that some cases remained unaware of their diagnosis, many cases had persistent symptoms, and controls had worse symptoms than cases. These findings suggest there are opportunities to improve management of this chronic disease.

Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call