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Microscopic colitis in older adults: impact, diagnosis, and management

Microscopic colitis (comprising lymphocytic and collagenous colitis, albeit an incomplete variant is gaining recognition as well) is a chronic, immune-mediated inflammatory state of the lower gastrointestinal tract (colon). The diagnosis requires diagnostic colonoscopy with characteristic histopatho...

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Autores principales: Fedor, Istvan, Zold, Eva, Barta, Zsolt
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260565/
https://www.ncbi.nlm.nih.gov/pubmed/35813189
http://dx.doi.org/10.1177/20406223221102821
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author Fedor, Istvan
Zold, Eva
Barta, Zsolt
author_facet Fedor, Istvan
Zold, Eva
Barta, Zsolt
author_sort Fedor, Istvan
collection PubMed
description Microscopic colitis (comprising lymphocytic and collagenous colitis, albeit an incomplete variant is gaining recognition as well) is a chronic, immune-mediated inflammatory state of the lower gastrointestinal tract (colon). The diagnosis requires diagnostic colonoscopy with characteristic histopathological findings. They have a propensity to present in senior populations (above 60 years of age), particularly women – who are approximately 2.5–3 times more likely to develop microscopic colitis. Preexisting other immune-inflammatory diseases are also shown to predispose patients for the development of microscopic colitis. The classic presentation is profuse watery diarrhea, often during the night or early morning hours. Fecal incontinence and abdominal pain are frequent as well. Thus, the disease impacts patients’ quality of life and well-being. The first described cases date back to the seventies and eighties of the twentieth century, thereby they can be considered fairly recently discovered disease states. Our understanding of the disease and its pathophysiology is still incomplete. Although there is a lack of unified recommendation for treatment, most clinicians prefer the use of budesonide, and most published guidelines regard this locally acting glucocorticoid as the therapy of choice. In our article, we aimed for a brief, noncomprehensive overview of the clinical significance, diagnosis, and management of microscopic colitis.
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spelling pubmed-92605652022-07-08 Microscopic colitis in older adults: impact, diagnosis, and management Fedor, Istvan Zold, Eva Barta, Zsolt Ther Adv Chronic Dis Review Microscopic colitis (comprising lymphocytic and collagenous colitis, albeit an incomplete variant is gaining recognition as well) is a chronic, immune-mediated inflammatory state of the lower gastrointestinal tract (colon). The diagnosis requires diagnostic colonoscopy with characteristic histopathological findings. They have a propensity to present in senior populations (above 60 years of age), particularly women – who are approximately 2.5–3 times more likely to develop microscopic colitis. Preexisting other immune-inflammatory diseases are also shown to predispose patients for the development of microscopic colitis. The classic presentation is profuse watery diarrhea, often during the night or early morning hours. Fecal incontinence and abdominal pain are frequent as well. Thus, the disease impacts patients’ quality of life and well-being. The first described cases date back to the seventies and eighties of the twentieth century, thereby they can be considered fairly recently discovered disease states. Our understanding of the disease and its pathophysiology is still incomplete. Although there is a lack of unified recommendation for treatment, most clinicians prefer the use of budesonide, and most published guidelines regard this locally acting glucocorticoid as the therapy of choice. In our article, we aimed for a brief, noncomprehensive overview of the clinical significance, diagnosis, and management of microscopic colitis. SAGE Publications 2022-07-05 /pmc/articles/PMC9260565/ /pubmed/35813189 http://dx.doi.org/10.1177/20406223221102821 Text en © The Author(s), 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Fedor, Istvan
Zold, Eva
Barta, Zsolt
Microscopic colitis in older adults: impact, diagnosis, and management
title Microscopic colitis in older adults: impact, diagnosis, and management
title_full Microscopic colitis in older adults: impact, diagnosis, and management
title_fullStr Microscopic colitis in older adults: impact, diagnosis, and management
title_full_unstemmed Microscopic colitis in older adults: impact, diagnosis, and management
title_short Microscopic colitis in older adults: impact, diagnosis, and management
title_sort microscopic colitis in older adults: impact, diagnosis, and management
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9260565/
https://www.ncbi.nlm.nih.gov/pubmed/35813189
http://dx.doi.org/10.1177/20406223221102821
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