Department of Gastroenterology, University College Hospital, London, UK.
Department of Gastroenterology, St Mark's Hospital, LNWH Trust, Harrow, UK.
Br J Hosp Med (Lond). 2020 Oct 2;81(10):1-7. doi: 10.12968/hmed.2020.0034. Epub 2020 Oct 6.
Microscopic colitis encompasses both collagenous and lymphocytic colitis and is a relatively common condition with rising incidence. Diagnosis is by colonoscopy (which is usually normal but may show some mild changes) and biopsies which reveal characteristic histological findings. Symptoms include non-bloody diarrhoea with urgency which may be associated with faecal incontinence and abdominal pain. Microscopic colitis is associated with a reduced health-related quality of life, and treatment is aimed at symptom control. Medications linked with the development of microscopic colitis, including proton pump inhibitors, non-steroidal anti-inflammatory drugs and selective serotonin-reuptake inhibitors, should be discontinued. If symptoms persist, budesonide is a licensed treatment for microscopic colitis which has been shown to be effective in clinical trials and real-world practice.
显微镜结肠炎包括胶原性结肠炎和淋巴细胞性结肠炎,是一种相对常见的疾病,发病率呈上升趋势。诊断依据是结肠镜检查(通常正常,但可能显示一些轻微改变)和活检,活检显示出特征性的组织学发现。症状包括非血性腹泻伴紧迫感,可能伴有大便失禁和腹痛。显微镜结肠炎与健康相关生活质量降低有关,治疗旨在控制症状。与显微镜结肠炎发展相关的药物,包括质子泵抑制剂、非甾体抗炎药和选择性 5-羟色胺再摄取抑制剂,应停用。如果症状持续存在,布地奈德是显微镜结肠炎的一种许可治疗方法,临床试验和实际应用均显示其有效。