Microscopic Colitis

Question 1

Microscopic colitis characterized by

Answer 1

chronic, watery diarrhea

Question 2

Patho

Core cause

severity of diarrhea correlates w

impair absorption of

collagen bands in collagenous colitis present a barrier to diffusion

Answer 2

Multifactorial

activation of mucosal immune system, leading to subepithelial immune response

degree of inflam changes in lamina propria

luminal NaCl, inc Cl sec

limiting absorption

Question 3

Common pop

CM

Answer 3

middle aged pt, women

chronic watery diarrhea
4-10 BM daily, w urgency, incontinence, nocturnal diarrhea

Question 4

Dx

stool studies

Lab studies

Test of choice

Appearance of mucosa

Answer 4

neg for leuk/blood

inc ESR/anemia

colonoscopy w random biopsy of proximal colon

edema, erythema, friability

Question 5

Biopsy findings

Collagenous vs lymphocytitic

Answer 5

mononuclear infiltrate in LP

C- subepithelial collagenous band

L- inc intraepithelial lymphs w monos

Question 6

Mx

Sx pts

Persistent

Answer 6

no intervention, avoid NSAIDs

Loperaide to dec freq/vol of stool

CS (budesonide)