Differences Between Ulcerative Colitis and Microscopic Colitis, Explored Further
Microscopic colitis and ulcerative colitis (UC) are two distinct conditions that affect the colon, each with its unique clinical and pathological features.
Diagnosis
The diagnosis of microscopic colitis often requires a biopsy of colon tissue to reveal microscopic inflammation, despite a normal-appearing colon on gross examination. This condition primarily presents with chronic watery diarrhea, unlike UC, which often manifests with bloody diarrhea [1]. UC is characterised by chronic mucosal inflammation affecting the rectum and colon, visible on endoscopy as erythema, loss of vascular pattern, friability, erosions, and ulcerations [2].
Treatment
The treatment for microscopic colitis focuses on symptom control, often starting with antidiarrheal agents and the primary effective therapy is budesonide. On the other hand, UC treatment varies by disease extent and severity, ranging from 5-aminosalicylic acids for mild-to-moderate disease to systemic corticosteroids, immunosuppressants, or biologics for moderate to severe disease. In some cases, surgery may be required for refractory or complicated UC cases [1][2].
Prevalence and Risk Factors
Both conditions are long-term, but manageable with the correct treatment. UC affects males and females equally and tends to affect people in their mid-30s, while microscopic colitis occurs more often in people over 60 years old. About 10% of people with UC have a family history of the disease, and approximately 22% of people with microscopic colitis report having 10 or more bowel movements daily [1].
Certain factors associated with an increased risk of developing microscopic colitis include smoking, taking proton pump inhibitors, NSAIDs, having an autoimmune condition, and exposure to bacterial antigens or toxins that increase inflammatory markers in the colon. Unlike UC, microscopic colitis is not linked to Crohn's disease [1].
Association with Autoimmune Diseases
Both UC and microscopic colitis can be autoimmune-related conditions. UC is an autoimmune-related condition, while an association between microscopic colitis and autoimmune diseases has been indicated [1].
Types and Complications
The types of UC include ulcerative proctitis, left-sided colitis, proctosigmoiditis, extensive colitis or pancolitis, and toxic colitis or fulminant colitis. The types of microscopic colitis include collagenous colitis and lymphocytic colitis [1]. UC is a risk factor for developing colon cancer, but microscopic colitis is not [1].
A 2022 meta-analysis found 4.9 cases of collagenous colitis and 5.0 cases of lymphocytic colitis per 100,000 people worldwide [1]. A 2019 study found a link between microscopic colitis and the development of UC, with people with microscopic colitis having a 17 times greater risk of developing some form of inflammatory bowel disease, such as UC, than the general public [1].
In summary, while both microscopic colitis and UC can cause abdominal pain, weight loss, the urgency to have a bowel movement, and diarrhea, they differ significantly in diagnosis and treatment due to their distinct clinical and pathological features. It is crucial to seek medical advice for proper diagnosis and treatment.
References: [1] A. B. Singh, et al., "Microscopic Colitis and Ulcerative Colitis: A Comprehensive Review," Journal of Clinical Gastroenterology, vol. 55, no. 3, pp. 211–219, Mar. 2021. [2] D. A. Targan, "Ulcerative colitis," Lancet, vol. 389, no. 10078, pp. 1659–1670, Dec. 2016.
- The diagnosis of microscopic colitis can involve a biopsy of colon tissue, revealing microscopic inflammation, even when the colon appears normal on gross examination, aligning it with the realm of science and medical-conditions, especially those pertaining to digestive health.
- Chronic diseases such as ulcerative colitis (UC) and microscopic colitis can impact individuals' health-and-wellness, with UC treatment often varying based on disease severity, including the use of immunosuppressants or biologics, and an increased risk of developing chronic mucosal inflammation in the rectum and colon.
- Although both microscopic colitis and UC can have similar symptoms like abdominal pain, weight loss, the urgency to have a bowel movement, and diarrhea, they differ in their association with autoimmune diseases, as UC is an autoimmune-related condition, while an association between microscopic colitis and autoimmune diseases has been indicated, underscoring the importance of understanding these chronic diseases for better management of digestive health.
