David
Co-Founder
This thread is for those of us diagnosed with or suspected of having Microscopic Colitis AKA Lymphocytic Colitis or Collagenous Colitis.
I will slowly update this first post about each form of Colitis so that it can be information to anyone reading it. In the meantime, welcome to the club. You can PM me for the secret handshake.
Microscopic Colitis
Microscopic colitis refers to two inflammatory medical conditions: Collagenous Colitis and Lymphocytic Colitis, both of which are outlined below. Please note that some patients exhibit signs of both LC and CC at different points of their disease suggesting to some researchers that the diseases are the same just at different stages.
Lymphocytic Colitis
Lymphocytic colitis is a subtype of microscopic colitis and is thought to be a rare condition characterized by lymphocytes in the epithelium and surrounding connective tissue. Symptoms include chronic diarrhea (96% of cases), abdominal pain (47%), and weight loss (41%).[goto=1a][1][/goto] In addition, the rarity of this disease is in question as more colonoscopy's with biopsies are performed (which is the only way to diagnose it). Lympocytic Colitis has about the same incidence rate is both sexes. The excessive intraepithelial lymphocytes observed in LC are predominantly CD4+ T cells rather than CD8+.
Collagenous Colitis
Collagenous Colitis is also a subtype of Microscopic Colitis and some experts feel it is the same thing as Lymphocytic Colitis. The only real difference between the two is Collagenous Colitis shows a thickening of the subepithelial collagen table which is the connective tissue between colonic glands. CC has a higher incidence rate in women.
Causes
The cause of these forms of Colitis are not known. There are theories that suggest long term use of NSAIDs such as motrin and aleve may play a part as well and anti anxiety as anti depression medications in the SSRI family.
Comorbid Issues
It has been found that many people with preexisting autoimmune conditions, such as celiac sprue, psoriasis and rheumatoid arthritis, are later diagnosed with microscopic colitis. Patients diagnosed with LC also have had uveitis, idiopathic pulmonary fibrosis, juvenile diabetes mellitus, pernicious anemia, autoimmune thyroid disease, and idiopathic thrombocytopenic purpura.
Those with Celiac Disease have a greatly increased chance of having microscopic Colitis. Anyone diagnosed with Celiac Disease should be tested for Microscopic Colitis and vice versa.
Diagnosis
The most effective way to diagnose Lymphocytic Colitis or Collagenous Colitis is via a colonoscopy where biopsies are taken. While 95% of patients with MC will have positive left colon biopsies, the rectosigmoid and right side of the colon should also be biopsied
Treatment
Step one is avoiding any aggravating drugs such as NSAIDs (Advil, Aleve, Motrin, etc). Long term use of Pepto Bismol (1-2 months) at 8 tablets per day has been shown to be affective in treating some patients with CC and LC.
Prescription Medications
Budesonide (Entocort), 6-MP and Prednisone have been shown to be effective in treating LC and CC.
Supplements
- David Chapman reports definitively positive results with this supplement.
Dietary Recommendations
Dietary recommendations are varied but they CAN be beneficial. Improvement has been seen with the [wiki]Specific Carbohydrate Diet[/wiki]. You may want to try various diets (stick with them for at least 3 months), keeping a food journal, and seeing what works for you and what does not.
Fitness Recommendations
High impact forms of fitness can cause additional pain and symptoms for many. But fitness is extremely important. Yoga, swimming, and bike riding are all low impact exercises that can be highly beneficial.
References
[pos]1a[/pos]- [1] http://gut.bmj.com/content/53/4/536.full
- Miehlke S, Madisch A, Karimi D, et al. Budesonide is effective in treating lymphocytic colitis: a randomized double-blind placebo-controlled study. Gastroenterology. Jun 2009;136(7):2092-100. [Medline].
- Baert F, Wouters K, D'Haens G, Hoang P, Naegels S, D'Heygere F, et al. Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis. Gut. Sep 1999;45(3):375-81. [Medline]
- Chande N, MacDonald JK, McDonald JW. Interventions for treating microscopic colitis: a Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials. Am J Gastroenterol. Jan 2009;104(1):235-41; quiz 234, 242. [Medline]
- http://www.gastrojournal.org/article/S0016-5085(11)00132-6/fulltext
- http://www.medscape.com/viewarticle/743426 - Celiac Disease and Microscopic Colitis
I will slowly update this first post about each form of Colitis so that it can be information to anyone reading it. In the meantime, welcome to the club. You can PM me for the secret handshake.
Microscopic Colitis
Microscopic colitis refers to two inflammatory medical conditions: Collagenous Colitis and Lymphocytic Colitis, both of which are outlined below. Please note that some patients exhibit signs of both LC and CC at different points of their disease suggesting to some researchers that the diseases are the same just at different stages.
Lymphocytic Colitis
Lymphocytic colitis is a subtype of microscopic colitis and is thought to be a rare condition characterized by lymphocytes in the epithelium and surrounding connective tissue. Symptoms include chronic diarrhea (96% of cases), abdominal pain (47%), and weight loss (41%).[goto=1a][1][/goto] In addition, the rarity of this disease is in question as more colonoscopy's with biopsies are performed (which is the only way to diagnose it). Lympocytic Colitis has about the same incidence rate is both sexes. The excessive intraepithelial lymphocytes observed in LC are predominantly CD4+ T cells rather than CD8+.
Collagenous Colitis
Collagenous Colitis is also a subtype of Microscopic Colitis and some experts feel it is the same thing as Lymphocytic Colitis. The only real difference between the two is Collagenous Colitis shows a thickening of the subepithelial collagen table which is the connective tissue between colonic glands. CC has a higher incidence rate in women.
Causes
The cause of these forms of Colitis are not known. There are theories that suggest long term use of NSAIDs such as motrin and aleve may play a part as well and anti anxiety as anti depression medications in the SSRI family.
Comorbid Issues
It has been found that many people with preexisting autoimmune conditions, such as celiac sprue, psoriasis and rheumatoid arthritis, are later diagnosed with microscopic colitis. Patients diagnosed with LC also have had uveitis, idiopathic pulmonary fibrosis, juvenile diabetes mellitus, pernicious anemia, autoimmune thyroid disease, and idiopathic thrombocytopenic purpura.
Those with Celiac Disease have a greatly increased chance of having microscopic Colitis. Anyone diagnosed with Celiac Disease should be tested for Microscopic Colitis and vice versa.
Diagnosis
The most effective way to diagnose Lymphocytic Colitis or Collagenous Colitis is via a colonoscopy where biopsies are taken. While 95% of patients with MC will have positive left colon biopsies, the rectosigmoid and right side of the colon should also be biopsied
Treatment
Step one is avoiding any aggravating drugs such as NSAIDs (Advil, Aleve, Motrin, etc). Long term use of Pepto Bismol (1-2 months) at 8 tablets per day has been shown to be affective in treating some patients with CC and LC.
Prescription Medications
Budesonide (Entocort), 6-MP and Prednisone have been shown to be effective in treating LC and CC.
Supplements
- David Chapman reports definitively positive results with this supplement.
Dietary Recommendations
Dietary recommendations are varied but they CAN be beneficial. Improvement has been seen with the [wiki]Specific Carbohydrate Diet[/wiki]. You may want to try various diets (stick with them for at least 3 months), keeping a food journal, and seeing what works for you and what does not.
Fitness Recommendations
High impact forms of fitness can cause additional pain and symptoms for many. But fitness is extremely important. Yoga, swimming, and bike riding are all low impact exercises that can be highly beneficial.
References
[pos]1a[/pos]- [1] http://gut.bmj.com/content/53/4/536.full
- Miehlke S, Madisch A, Karimi D, et al. Budesonide is effective in treating lymphocytic colitis: a randomized double-blind placebo-controlled study. Gastroenterology. Jun 2009;136(7):2092-100. [Medline].
- Baert F, Wouters K, D'Haens G, Hoang P, Naegels S, D'Heygere F, et al. Lymphocytic colitis: a distinct clinical entity? A clinicopathological confrontation of lymphocytic and collagenous colitis. Gut. Sep 1999;45(3):375-81. [Medline]
- Chande N, MacDonald JK, McDonald JW. Interventions for treating microscopic colitis: a Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials. Am J Gastroenterol. Jan 2009;104(1):235-41; quiz 234, 242. [Medline]
- http://www.gastrojournal.org/article/S0016-5085(11)00132-6/fulltext
- http://www.medscape.com/viewarticle/743426 - Celiac Disease and Microscopic Colitis
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