The Frequency of Microscopic and Focal Active Colitis in Patients with Irritable Bowel Syndrome

Overview

Journal BMC Gastroenterol

Publisher Biomed Central

Specialty Gastroenterology

Date 2011 Sep 2

PMID 21880133

Citations 12

Authors

Kamil Ozdil

Abdurrahman Sahin

Turan Calhan

Resul Kahraman

Adil Nigdelioglu

Umit Akyuz

Haci M Sokmen

Affiliations

Soon will be listed here.

Abstract

Background: Irritable bowel syndrome (IBS) is a chronic functional bowel disorder. The frequency of microscopic colitis and focal active colitis in the colonic mucosa has been investigated in IBS patients.

Methods: Between June 2007 and September 2010, 378 patients (between 16 and 84 years) were recruited prospectively. Of these 378 patients, 226 patients were diagnosed with IBS using the Rome III criteria. 152 control patients were also enrolled who were undergoing colonoscopy for colorectal cancer screening or investigation of anemia. Histopathological abnormalities identified during colonoscopy were compared between the IBS and control groups.

Results: The average age of the IBS group was 46.13 ± 14.16 years and and the average age of the control group was 57.01 ± 13.07 years. The prevalence of microscopic colitis (MC) in the diarrhea predominant and the mixed subgroup of IBS patients was 4.32% (7/162) whereas in all IBS patients, the prevalence was 3.09% (7/226). MC was not found in the 152 control cases, (p = 0.045). Lymphocytic colitis was seen in 7 IBS patients, with 1 case in the mixed group and 6 cases in the diarrhea group and there was a significant difference in the frequency of lymphocytic colitis between the IBS subgroups (p < 0.01). Focal active colitis was found in 6.6% (15/226) of the IBS patients and in none of the controls (p < 0.01), and there was no differences between IBS subtypes.

Conclusion: Microscopic colitis was more often found in the diarrhea predominant/mixed subgroups of IBS patients and in patients who were older women. In patients who are older woman with non-constipated IBS, it may be reasonable to perform a biopsy to screen for microscopic colitis. Focal active colitis was significantly increased in patients with IBS compared to controls.

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References

Olesen M, Eriksson S, Bohr J, Jarnerot G, Tysk C . Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993-1998. Gut. 2004; 53(3):346-50. PMC: 1773978. DOI: 10.1136/gut.2003.014431. View

Lindstrom C . 'Collagenous colitis' with watery diarrhoea--a new entity?. Pathol Eur. 1976; 11(1):87-9. View

Bowling T, Price A, Al-Adnani M, Fairclough P, Menzies-Gow N, Silk D . Interchange between collagenous and lymphocytic colitis in severe disease with autoimmune associations requiring colectomy: a case report. Gut. 1996; 38(5):788-91. PMC: 1383166. DOI: 10.1136/gut.38.5.788. View

Zwas F, Cirillo N, El-Serag H, Eisen R . Colonic mucosal abnormalities associated with oral sodium phosphate solution. Gastrointest Endosc. 1996; 43(5):463-6. DOI: 10.1016/s0016-5107(96)70286-9. View

Olesen M, Eriksson S, Bohr J, Jarnerot G, Tysk C . Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients. Gut. 2004; 53(4):536-41. PMC: 1774011. DOI: 10.1136/gut.2003.023440. View

Olden K . Diagnosis of irritable bowel syndrome. Gastroenterology. 2002; 122(6):1701-14. DOI: 10.1053/gast.2002.33741. View

Talley N, Spiller R . Irritable bowel syndrome: a little understood organic bowel disease?. Lancet. 2002; 360(9332):555-64. DOI: 10.1016/S0140-6736(02)09712-X. View

Loftus E . Microscopic colitis: epidemiology and treatment. Am J Gastroenterol. 2003; 98(12 Suppl):S31-6. DOI: 10.1016/j.amjgastroenterol.2003.10.008. View

Balboa A, Mearin F, Badia X, Benavent J, Caballero A, Dominguez-Munoz J . Impact of upper digestive symptoms in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2006; 18(12):1271-7. DOI: 10.1097/01.meg.0000243870.41207.2f. View

10.

Mosnier J, Larvol L, Barge J, Dubois S, De La Bigne G, Henin D . Lymphocytic and collagenous colitis: an immunohistochemical study. Am J Gastroenterol. 1996; 91(4):709-13. View

11.

Celebi S, Acik Y, Deveci S, Bahcecioglu I, Ayar A, Demir A . Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol. 2004; 19(7):738-43. DOI: 10.1111/j.1440-1746.2004.03367.x. View

12.

Wong N, Penman I, Campbell S, Lessells A . Microscopic focal cryptitis associated with sodium phosphate bowel preparation. Histopathology. 2000; 36(5):476-8. View

13.

Hahn B, Watson M, Yan S, Gunput D, Heuijerjans J . Irritable bowel syndrome symptom patterns: frequency, duration, and severity. Dig Dis Sci. 1999; 43(12):2715-8. DOI: 10.1023/a:1026663613695. View

14.

Thompson W, Longstreth G, Drossman D, Heaton K, Irvine E, Muller-Lissner S . Functional bowel disorders and functional abdominal pain. Gut. 1999; 45 Suppl 2:II43-7. PMC: 1766683. DOI: 10.1136/gut.45.2008.ii43. View

15.

Jawhari A, Talbot I . Microscopic, lymphocytic and collagenous colitis. Histopathology. 1996; 29(2):101-10. DOI: 10.1046/j.1365-2559.1996.d01-498.x. View

16.

Yantiss R, Odze R . Optimal approach to obtaining mucosal biopsies for assessment of inflammatory disorders of the gastrointestinal tract. Am J Gastroenterol. 2009; 104(3):774-83. DOI: 10.1038/ajg.2008.108. View

17.

Limsui D, Pardi D, Camilleri M, Loftus Jr E, Kammer P, Tremaine W . Symptomatic overlap between irritable bowel syndrome and microscopic colitis. Inflamm Bowel Dis. 2007; 13(2):175-81. DOI: 10.1002/ibd.20059. View

18.

Pardi D, Smyrk T, Tremaine W, Sandborn W . Microscopic colitis: a review. Am J Gastroenterol. 2002; 97(4):794-802. DOI: 10.1111/j.1572-0241.2002.05595.x. View

19.

Xin W, Brown P, Greenson J . The clinical significance of focal active colitis in pediatric patients. Am J Surg Pathol. 2003; 27(8):1134-8. DOI: 10.1097/00000478-200308000-00011. View

20.

Read N, Krejs G, Read M, Santa Ana C, Morawski S, Fordtran J . Chronic diarrhea of unknown origin. Gastroenterology. 1980; 78(2):264-71. View