Lukáš Karel, Mandys Václav
Interni Klinika 1. LF UK a VFN, Praha.
Cas Lek Cesk. 2013;152(2):59-66.
Microscopic colitis is characterized by chronic or intermittent watery diarrhoea. Microscopic colitis is a common cause of chronic diarrhoea in predominantly older adults. The underlying mechanism in the pathogenesis of microscopic colitis remains unspecified. Microscopic colitis including colitis collagenous, lymphocytic, microscopic colitis with incomplete findings, minimal change colitis, eosinophilic colitis, Brainerd´s diarrhoea, graft-versus-host disease, mastocytic enterocolitis and postinfectious irritable bowel syndrome. Careful consideration of the clinical features and colonic mucosal biopsies usually lead to correct diagnosis. Treatments of microscopic colitis were based primarily on case reports and personal experience. Many medications have been proposed that either offer symptomatic relief (loperamide, cholestyramine) or had anti-inflammatory or immunosuppressive properties (aminosalicylates, steroids, adalimumab, azathioprine).
显微镜下结肠炎的特征为慢性或间歇性水样腹泻。显微镜下结肠炎是主要发生于老年人的慢性腹泻的常见病因。显微镜下结肠炎发病机制的潜在机制仍不明确。显微镜下结肠炎包括胶原性结肠炎、淋巴细胞性结肠炎、检查结果不完整的显微镜下结肠炎、微小病变性结肠炎、嗜酸性粒细胞性结肠炎、布雷纳德腹泻、移植物抗宿主病、肥大细胞性小肠结肠炎和感染后肠易激综合征。仔细考虑临床特征和结肠黏膜活检通常可得出正确诊断。显微镜下结肠炎的治疗主要基于病例报告和个人经验。已提出许多药物，要么可缓解症状（洛哌丁胺、考来烯胺），要么具有抗炎或免疫抑制特性（氨基水杨酸类药物、类固醇、阿达木单抗、硫唑嘌呤）。
