Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
The key diagnostic criteria for microscopic colitis in adults presenting with chronic diarrhea include:
- Chronic, non-bloody watery diarrhea persisting for weeks to months, often without systemic symptoms such as weight loss or fever, is the typical clinical presentation NICE NG130 Münch & Langner 2015.
- Colonoscopy findings are usually normal or show minimal mucosal changes,1 Zabana et al. 2017.
- Histological examination of colonic biopsies is essential,10 µm) with increased intraepithelial lymphocytes for collagenous colitis, or increased intraepithelial lymphocytes (>20 per 100 epithelial cells) without collagen band thickening for lymphocytic colitis Münch & Langner 2015Pardi 2017.
- Exclusion of other causes of chronic diarrhea,1 Pardi 2017.
- Multiple biopsies from different colonic segments, including the right and left colon,
In summary, the diagnosis relies on clinical suspicion in adults with chronic watery diarrhea, normal endoscopic appearance, and confirmatory histopathology showing either collagenous or lymphocytic colitis patterns. This integrated approach from UK guidelines and recent literature ensures accurate diagnosis and appropriate management NICE NG130 Münch & Langner 2015Zabana et al. 2017Pardi 2017.
Key References
- NG130 - Ulcerative colitis: management
- CG61 - Irritable bowel syndrome in adults: diagnosis and management
- CG118 - Colorectal cancer prevention: colonoscopic surveillance in adults with ulcerative colitis, Crohn's disease or adenomas
- (Münch and Langner, 2015): Microscopic colitis: clinical and pathologic perspectives.
- (Zabana et al., 2017): Advances for improved diagnosis of microscopic colitis in patients with chronic diarrhoea.
- (Pardi, 2017): Diagnosis and Management of Microscopic Colitis.