AI Article Synopsis
- Microscopic colitis (MC) is gaining clinical importance but remains poorly understood due to challenges in data interpretation and misclassification of the disease.
- The diagnosis relies on histology and immunohistopathology, requiring multiple colon biopsies, and there are ongoing debates about its subtypes and causes.
- While budesonide is often effective for treating MC, some cases don't respond, leading to a consideration of immunomodulators and biologics as second-line treatment options.
Article Abstract
Although the clinical importance of microscopic colitis (MC) is highly increasing, however, the disease is still mysterious due to several challenges. Recent MC data depend mainly on doubts and uncertainties leading to misclassification. This review discussed the current knowledge gaps about MC and various controversies regarding its subtypes, pathogenesis, and management. The diagnosis of MC is based mainly on histology and immunohistopathology which can discriminate two subtypes. However, transitional forms are often associated with misclassification. The site and number of the colon biopsies have been agreed upon as at least three from each side of the colon (right and left) with a total of six. There is no credible, clear explanation for the increased incidence. The etiopathogenesis is possibly multifactorial with a high impact on the immunological background. It is proposed that MC would be the initiative of irritable bowel disease, which needs further data clarification. Although budesonide is an effective treatment in most cases, budesonide-refractory MC represents a significant clinical challenge. Therefore, immunomodulators and biologics are now well-thought to be the second-line choice for treatment.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10889481 | PMC |
| http://dx.doi.org/10.7759/cureus.52862 | DOI Listing |
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