van der Wouden E J, Karrenbeld A, Kleibeuker J H, Dijkstra G
Department of Gastroenterology, Isala Clinics, Zwolle, the Netherlands.
Neth J Med. 2009 Feb;67(2):41-5.
Chronic diarrhoea is a frequent complaint in clinical practice. Microscopic colitis is the cause of this symptom in 10% of these cases and the prevalence is rising. To exclude microscopic colitis a colonoscopy with multiple biopsies of different regions of the colon is mandatory. A sigmoidoscopy alone is insufficient. Two histopathological types of microscopic colitis can be distinguished: collagenous colitis and lymphocytic colitis. Nowadays, there is sufficient evidence to recommend budesonide as the first-choice treatment. Bismuth can also be recommended, but this drug is not easily available in the Netherlands. Evidence of efficacy of other drugs is scant.
慢性腹泻是临床实践中常见的主诉。在这些病例中，显微镜下结肠炎是导致该症状的原因，占10%，且患病率正在上升。要排除显微镜下结肠炎，必须进行结肠镜检查并对结肠不同区域进行多次活检。仅进行乙状结肠镜检查是不够的。显微镜下结肠炎可分为两种组织病理学类型：胶原性结肠炎和淋巴细胞性结肠炎。如今，有充分的证据推荐布地奈德作为首选治疗药物。铋剂也可推荐使用，但该药物在荷兰不易获得。其他药物疗效的证据较少。
