Microscopic colitis is a chronic inflammatory condition of the large bowel wherein the patient experiences watery diarrhea. Although it is an inflammatory condition but the characteristics are different from other gastrointestinal inflammatory conditions such as ulcerative colitis and Crohn’s disease. The inflammation in the colon cells in microscopic colitis are only seen when the cells are put under the microscope, thus the condition named as microscopic colitis. The microscopic colitis comprises the lymphocytic colitis and collagenous colitis. The cause of the disease is not known however certain factors such as infection, drugs and other diseases increases the risk of the microscopic colitis. The treatment is symptomatic as the condition is self-limiting.
What Are The Complications Of Microscopic Colitis?
Although the microscopic colitis is benign, and the outcome is favorable, but sometimes the disease results in various complications. Most of the complications of the microscopic colitis are caused in collagenous colitis condition. Following are the complications that may occur due to microscopic colitis:
Celiac Disease: Celiac disease is present in many patients who are diagnosed with the microscopic colitis. Celiac disease is a serious autoimmune disease that primarily affects the gastrointestinal system.
Colonic Ulcerations: The microscopic colitis may sometimes lead to colonic ulcerations as the underlying connective tissue gets damaged in the collagenous colitis and thereby exposing the colonic surface. Further, the colonic ulceration may be caused due to the use of anti-inflammatory drugs having GIT side effects.
Colonic Fracturing: The microscopic colitis is diagnosed with the analysis of the cells of the colon under the microscope. Sometimes, during the extraction of the tissue, there is a colon surface damage, leading to further complication including bloody diarrhea.
Ulcerative Colitis And Crohn’s Disease: Although the chances of transforming microscopic colitis to ulcerative colitis and Crohn’s disease are rare, but few cases have been reported where the microscopic colitis is progressed in to ulcerative colitis or Crohn’s disease.
Malignancy: As the disease is not superficially exposed and the cellular changes do not occur, there are very rare chances of microscopic colitis progressing in to cancer. However, very rare cases of colon cancer along with microscopic colitis have been reported.
Cat Scratch Colon: When the colon is characterized by erythematous linear breaks and looks like a cat scratches, it is known as cat scratch colon. The condition is believed to be associated with the collagenous colitis. The reason for this condition may also be attributed to colonoscopy.
Spontaneous Colonic Perforation: The collagen deposition in the submucosal area of the colon may lead to spontaneous colon perforation and may also cause spontaneous peritonitis.
Complication Due To Diagnostics Methods: The methods used to diagnose the microscopic colitis have their own complications. This may be due to insertion of barium contrast agents or air insufflation.
Dehydration And Electrolytic Imbalance: The major symptom of the microscopic colitis is the watery diarrhea. This will sweep out the important electrolytes from the body along with water and cause severe dehydration and deficiency of electrolytes. The electrolytes are essential for the normal functioning of vital organs. Further, in chronic diarrhea, the patient experiences symptoms of malnutrition due to poor absorption of nutrients.
Symptoms of Microscopic Colitis
The symptoms of microscopic colitis depend upon the severity of the disease. If the disease is chronic and severe, the symptoms take longer to manage. Following are the symptoms of the disease:
- Non-bloody watery diarrhea
- Nocturnal diarrhea
- Diffused abdominal pain
- Weight loss
- Fecal incontinence
- Joint and muscle pain
Although microscopic colitis is benign and a self-limiting condition which requires only symptomatic relief, in some conditions, the situation become more complicated and requires aggressive treatment. Some of the complications may be due to the diagnostic procedures used to diagnose microscopic colitis while other complications are the result of progression of disease. The complications may include Celiac disease, colon cancer, Crohn’s disease, ulcerative colitis, colonic perforations, colonic fracturing and cat scratch colon.
- Mayo Clinic. (2021). Microscopic Colitis. https://www.mayoclinic.org/diseases-conditions/microscopic-colitis/symptoms-causes/syc-20351487
- National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Microscopic Colitis. https://www.niddk.nih.gov/health-information/digestive-diseases/microscopic-colitis
- Boynton, W., & Floch, M. H. (2015). New strategies for the management of diarrhea-predominant irritable bowel syndrome: the role of bile acid sequestrants and low-dose antidepressants. Journal of Clinical Gastroenterology, 49(7), 542-546.