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What Are The Common Causes Of Microscopic Colitis?

Colitis refers to an inflammation of the large intestine or the colon. Microscopic colitis is a condition where this colitis is not visible to the naked eye though a normal colonoscopy or a sigmoidoscopy. There is a need for microscopic examination of a sample of the tissue in order to confirm the diagnosis of this condition. Profuse and a persistent watery diarrhea is the characteristic sign of this disease.

Microscopic colitis is of two types – collagenous colitis and lymphocytic colitis.

  • In collagenous colitis, a thick protein (collagen) layer forms in the colon tissue.
  • In lymphocytic colitis, lymphocytes, that is the white blood tissues, increase in the colon tissue.

What Are The Common Causes Of Microscopic Colitis?

What Are The Common Causes Of Microscopic Colitis?

The exact cause of this disease is not yet known. Researches are still going on to find the exact cause.

  • Some researchers speculate that microscopic colitis is an auto-immune disorder, just like ulcerative colitis. However, the fact has not been established yet.
  • Some theories state that microscopic colitis is caused due to prolonged use of certain medications. These medications are responsible for the inflammation of the colon and hence there might be a link between this condition and such drugs. However, this theory also is not yet proven.
  • Some find that the bacteria that release toxins that irritate the colon, may be a causative factor for the inflammation in the colon.
  • Some others find that certain viruses that trigger an inflammatory response in the colon may be the cause of microscopic colitis.
  • Also, there is a speculation that if the bile acid is not absorbed properly, it might cause inflammation in the colon, leading to microscopic colitis.
  • Some autoimmune diseases may also be a causative factor, according to some researchers.

There are also certain factors, which increase the risk of getting this condition of microscopic colitis. The following factors may be considered as risk factors:

  • A genetic connection is speculated in between microscopic colitis and a history in the family suggestive of irritable bowel syndrome.
  • People with this condition are sometimes seen to have a co-existent auto immune disorder like thyroid disease, rheumatoid arthritis or type 1 diabetes.
  • Also, age could be a risk factor. This condition seems to be occurring mostly in people aged above 50-55. Also, it is more common in females than in males. This may be because the hormones decrease in women after menopause.
  • Smoking is a potential risk factor for microscopic colitis according to recent studies. There is a connection between this condition and smoking. This is especially evident in the younger age group.

Symptoms of Microscopic Colitis

Microscopic colitis may present with the following symptoms-

  • There is a persistent watery diarrhea. The diarrhea may be profuse and is chronic.
  • There may be associated abdominal cramps and also some pain.
  • There may be nausea accompanied with a loss of appetite.
  • Due to the diarrhea, and low intake of food, there may be a weight loss.
  • There may be dehydration due to severe loss of fluids from the body.
  • As a result of dehydration, there might be headache.
  • Fecal incontinence can also be seen.
  • There might be bloating and gassy feeling in the stomach
  • Blood is usually not present in the stools.
  • If the diarrhea continues for more than two weeks, then a medical opinion is to be sought Immediately.

Microscopic colitis has no known cure. However, the condition is still treatable. The line of treatment includes usage of anti-diarrheal, anti-inflammatory medicines, upping the fluid intake to tackle dehydration and electrolyte supplements to restore the electrolyte loss. With prompt and efficient treatment, the symptoms of the disease can be managed to a good extent. If the treatment is carried out along with some major recommended dietary changes, then it may prove to be immensely beneficial in tackling the symptoms of microscopic colitis.


  1. Mayo Clinic. (2021). Microscopic Colitis. https://www.mayoclinic.org/diseases-conditions/microscopic-colitis/symptoms-causes/syc-20351487
  2. National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Microscopic Colitis. https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis
  3. Cleveland Clinic. (2021). Microscopic Colitis: Diagnosis and Treatment. https://my.clevelandclinic.org/health/diseases/17712-microscopic-colitis-diagnosis-and-treatment

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 30, 2023

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