Microscopic colitis is a chronic bowel condition that can affect a person’s quality of life. However, treatments and lifestyle changes can effectively treat microscopic colitis.

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Microscopic colitis (MC) is a type of inflammatory bowel disease (IBD) that causes chronic gastrointestinal symptoms. About 700,000 people in the United States have MC.

This article looks at microscopic colitis and its types, symptoms, causes, and diagnosis. It also reviews its treatments, alternative remedies, how it compares to ulcerative colitis, and frequently asked questions.

MC is a condition where the inner lining of the colon becomes inflamed. MC is a chronic condition that may come and go throughout a person’s life. Doctors are not sure what causes people to develop MC.

MC can have a significant negative impact on a person’s quality of life. However, people with MC rarely develop severe or life threatening complications, such as colon cancer.

MC affects people aged 60 and older more often, but a person can have MC at any age. Females are almost three times more likely to develop MC than males.

Medical professionals classify MC into two types. Each type causes different changes in a person’s colon tissue:

  • Collagenous colitis (CC): CC is where the layer of collagen under the colon lining is thicker than normal. The colon lining may also have more white blood cells than normal.
  • Lymphocytic colitis (LC): LC is where the colon lining contains more white blood cells than normal. The collagen layer under the colon lining is still normal or only slightly thicker than normal.

The symptoms and treatments are the same for either type of MC.

The most common symptom of MC is diarrhea. People with MC have diarrhea that is:

  • chronic
  • watery
  • not bloody
  • occurs at night

Other symptoms of MC can include:

  • abdominal pain
  • weight loss
  • urgent need to have a bowel movement
  • fecal incontinence, or not being able to control a bowel movement
  • tiredness

MC symptoms can start suddenly or gradually and worsen over time. Symptoms can also disappear and then come back periodically.

Doctors are not yet sure what causes MC. However, experts believe people may be more at risk of developing MC if they:

Taking certain medications may also raise a person’s risk of developing MC. These include:

To diagnose MC, doctors first rule out any other cause of a person’s symptoms. A doctor will:

  • ask about a person’s symptoms
  • physically examine a person
  • check whether the person has any MC risk factors

Medical professionals can only confirm a person’s MC using a biopsy, or sample, of a person’s colon tissue. This is because the inflammation of a person’s colon with MC is only visible using a microscope.

Doctors use a colonoscopy to obtain these tissue samples. They then examine the samples under a microscope to confirm whether a person’s colon lining is inflamed.

A colonoscopy is a procedure that uses a camera at the end of a flexible tube to look at a person’s colon. During a colonoscopy, a doctor takes small sample pieces of a person’s colon tissue. They then use the sample to confirm a person’s MC diagnosis or check the effect of MC treatments.

Doctors can effectively treat a person’s MC using medication to improve or stop symptoms. These medications include:

In rare cases, doctors may treat a person’s MC with surgery. A person normally only needs surgery if medication has not cured their MC.

A person may improve their MC symptoms by changing what they eat and drink. Doctors may recommend a person avoids or limits their intake of certain foods or substances. Which foods and substances to avoid or limit can depend on the person’s symptoms and health conditions.

Substances to avoid may include:

  • alcohol
  • caffeine
  • artificial sweeteners

If a person has celiac disease, doctors may recommend they avoid gluten. Likewise, doctors may recommend people avoid milk and milk products if they are lactose intolerant.

Research suggests using probiotics can improve MC symptoms. However, researchers noted the current evidence is very limited. They recommend further studies to see whether probiotics or other supplements can treat MC symptoms.

Learn more about the microscopic colitis diet.

Ulcerative colitis (UC) and MC mostly share the same symptoms. However, one feature can differ: People with UC have blood in their diarrhea, whereas people with MC have no blood in their diarrhea.

If a person has UC, their colon lining inflammation is usually visible to doctors during a colonoscopy. For MC, doctors can only detect inflammation by examining colon tissue with a microscope.

However, a biopsy may also be needed to determine whether a person has UC if it is not visible on imaging tests.

Read more about ulcerative colitis vs. microscopic colitis.

Below are some frequently asked questions about microscopic colitis.

How serious is microscopic colitis?

MC is normally not very serious. People with MC only have serious complications in rare cases. Doctors can usually effectively treat a person’s MC with medication.

How do you get rid of microscopic colitis?

Medication can relieve and cure MC symptoms. However, symptoms may return. Changes to a person’s lifestyle, such as stopping smoking, can also help treat their MC.

What does a microscopic colitis flare feel like?

A microscopic colitis flare feels like having sudden, watery, and frequent diarrhea. MC flare-ups may also cause stomach cramps and abdominal pain.

Is microscopic colitis an autoimmune disease?

Some doctors think MC may be an autoimmune disease. There are some links between autoimmune conditions and MC, but researchers continue to investigate these links.

Microscopic colitis is a condition that can come and go over a person’s life. Doctors do not yet know exactly why a person develops MC.

MC symptoms can impair a person’s quality of life. However, doctors can effectively treat MC with medications, allowing people with MC to improve or eliminate their symptoms significantly.