Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.
Dig Liver Dis. 2012 May;44(5):384-8. doi: 10.1016/j.dld.2011.12.017. Epub 2012 Jan 20.
Often previously overlooked, microscopic colitis, including collagenous colitis and lymphocytic colitis, has now emerged as a common cause of chronic diarrhoea.
To evaluate the prevalence and incidence of microscopic colitis in patients with diarrhoea of unknown aetiology.
271 consecutive patients who were referred to the General Hospital of Tomelloso from April 2008 to December 2010 for diarrhoea of unknown aetiology underwent a full colonoscopy to obtain biopsy samples to diagnose microscopic colitis on the basis of commonly accepted histological criteria. All patients were classified according to the Roma III criteria for diarrhoea-dominant irritable bowel syndrome.
In 234/271 consecutive patients with normal endoscopic appearance we observed 32/234 patients with microscopic colitis (30 lymphocytic colitis and 2 collagenous colitis) with a prevalence of microscopic colitis of 48 cases/100,000 inhabitants (95%CI: 30-65) and mean annual standardised incidence of 18 cases/100,000 inhabitants (95%CI: 16.0-20.0). Analysing only the patients that met the Roma III criteria (84/271), we observed 10.7% microscopic colitis diagnosis, with higher risk in the presence of autoimmune disease, seronegative celiac disease and intake of non-steroidal anti-inflammatory drugs.
Microscopic colitis was found in 13.7% of patients with chronic diarrhoea. Microscopic colitis is present in a relevant proportion of symptomatic patients meeting diagnostic criteria for irritable bowel syndrome (10.7%).
包括胶原性结肠炎和淋巴细胞性结肠炎在内的显微镜下结肠炎，过去常常被忽视，现在已成为慢性腹泻的常见病因。
评估原因不明的腹泻患者中显微镜下结肠炎的患病率和发病率。
2008 年 4 月至 2010 年 12 月，因原因不明的腹泻而被转诊至托梅略索综合医院的 271 例连续患者接受了全结肠镜检查，以获取活检样本，根据公认的组织学标准诊断显微镜下结肠炎。所有患者均根据罗马 III 标准诊断为腹泻型肠易激综合征。
在 271 例连续患者中，234 例内镜表现正常，我们观察到 32 例显微镜下结肠炎（30 例淋巴细胞性结肠炎和 2 例胶原性结肠炎），显微镜下结肠炎的患病率为 48 例/10 万居民（95%CI：30-65），平均年标准化发病率为 18 例/10 万居民（95%CI：16.0-20.0）。仅分析符合罗马 III 标准的患者（271 例中的 84 例），我们观察到 10.7%的显微镜下结肠炎诊断，在存在自身免疫性疾病、血清阴性乳糜泻和非甾体抗炎药摄入时，风险更高。
慢性腹泻患者中有 13.7%发现显微镜下结肠炎。在符合肠易激综合征诊断标准的有症状患者中，显微镜下结肠炎的存在比例较高（10.7%）。
