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Microscopic colitis

Colitis microscopica (collagenosa / lymphocytaria) · Mikroskopická kolitida

What it is

Chronic watery diarrhoea from a colon that looks normal through the scope but is inflamed under the microscope; common in older women, and some drugs trigger it.

Symptoms & signs

  • Watery non-bloody diarrhoea, often at night
  • urgency and incontinence
  • cramps and bloating
  • weight loss
  • tiredness

🚩 Get help if…

  • call 112 / 911 now Dizzy, very thirsty and passing little urine
  • see a doctor soon Blood in the stool
  • see a doctor soon Losing weight without trying
  • see a doctor soon Diarrhoea for over 6 weeks after age 60

Where it strikes

Medical treatment

  • Colonoscopy with biopsies from several places
  • stop culprit drugs (NSAIDs, PPIs, SSRIs, statins)
  • budesonide
  • loperamide or bile-acid binders
  • immunomodulators or biologics if it resists

Natural & lifestyle

  • Stop smoking
  • cut caffeine, alcohol and dairy if they worsen it
  • keep hydrated

Emerging & experimental

  • Vedolizumab and anti-TNF for resistant cases
  • faecal microbiota transplant

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Boswellia serrata — a small trial helped collagenous colitis early / small studies
  • Probiotics — trials disagree mixed evidence
  • Gluten-free diet — coeliac disease often comes with it; otherwise anecdotal anecdotal / traditional

ICD codes