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New Symptom Index Can Assess Severity of Microscopic Colitis

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Microscopic colitis -- one of three types of colitis -- is often confused with other bowel conditions, and although it is not as severe as other forms of inflammatory bowel disease (IBD), it usually takes a colonoscopy to diagnose it.

So it comes as good news that the Mayo Clinic has devised a tool that can help doctors assess your condition and find out if it’s really microscopic colitis, a common reason for chronic diarrhea.

Called the Microscopic Colitis Disease Activity Index, the tool was revealed by the Mayo Clinic at the American College of Gastroenterology Annual Scientific Meeting in October 2011.

“Until now, physicians have not had a way to objectively and consistently score the severity of a patient’s disease beyond simply counting the number of bowel movements per day,” said Dr. Darrell Pardi, a Mayo Clinic gastroenterologist who authored the study. Along with incidences of diarrhea, the new assessment tool looks at abdominal pain, urgency and incontinence.

The Disease Activity Index will be useful in future studies of microscopic colitis, as researchers compare treatments, said the Mayo Clinic in its Oct. 31, 2011, press release.

As the Mayo Clinic explained, microscopic colitis is a chronic, inflammatory condition of the large intestine, or colon, that causes watery diarrhea and occasional abdominal pain. The disorder gets its name from the way it’s identified -- microscopic examination of tissue obtained through a colonoscopy.

Among older patients with chronic diarrhea, microscopic colitis is said to be the cause of perhaps 30 percent of cases.

But the disorder is not to be confused with ulcerative colitis, which produces ulcers in the lining of the colon and rectum, or with indeterminate colitis, the name doctors use when it’s hard to distinguish whether the patient’s intestinal inflammation is ulcerative colitis or Crohn’s disease.

Unlike other forms of inflammatory bowel disease, microscopic colitis does not lead to colon cancer and rarely requires any surgery, said the National Digestive Diseases Information Clearinghouse. Still, it can bring about pain and discomfort.

The new Mayo Clinic tool also might prove helpful in distinguishing microscopic colitis from irritable bowel syndrome, which has to do with the everyday functioning of the colon. Symptoms are similar, but irritable bowel syndrome often encompasses both diarrhea and constipation.

As for the signs of microscopic colitis, a primary clue is the incidence of watery and non-bloody diarrhea that can last for weeks, months or years, even if there are long periods when the diarrhea goes away. Other possible symptoms include: abdominal cramps or pain, bloating, mild weight loss, dehydration, nausea, weakness and fecal incontinence.

While the cause of microscopic colitis is unknown, researchers are looking at various substances that might trigger inflammation when absorbed into the gastrointestinal tract; the trigger could be bacteria, pollen, food, medication, or even the body’s own cells. A genetic tendency toward microscopic colitis is also a possibility.

Treatment of microscopic colitis usually starts with eliminating certain foods and medications that are suspected of causing the diarrhea, then trying medications that control diarrhea and inflammation. Last resorts include corticosteroids and surgical removal of a section of the small intestine.


“Mayo Clinic Develops New Way to Rate Severity of Colitis, a Common Cause of Diarrhea.” MayoClinic.org. Web. 28 Nov. 2011. http://www.mayoclinic.org/news2011-rst/6521.html

“Microscopic Colitis: Collagenous Colitis and Lymphocytic Colitis.” National Digestive Diseases Information Clearinghouse (NDDIC). Web. 28 Nov. 2011. http://digestive.niddk.nih.gov/ddiseases/pubs/microcolitis

Gromisch, Maryann. “Microscopic Colitis: Misdiagnosed as Irritable Bowel Syndrome.” EmpowHER.com. Web. 28 Nov. 2011. https://www.empowher.com/colitis/content/microscopic-colitis-misdiagnosed-irritable-bowel-syndrome

Reviewed November 29, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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