Microscopic colitis: a population-based case series over a nine year period within Northern Ireland

Michelle Moore, Helen G Coleman, Patrick B Allen, Maurice B Loughrey

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Abstract

Aim
We report clinicopathological experience of microscopic colitis in a population‐based case series in Northern Ireland, over a nine year period.

Method
The pathology laboratory information system within a large teaching centre serving two healthcare trusts was interrogated for cases coded between 2008 and 2016 as collagenous colitis (CC) or lymphocytic colitis (LC). Demographic, clinical and follow up information was collected from healthcare records.

Results
A total of 326 new diagnoses of MC were identified, an average annual incidence of 6.7 per 100,000 population. The average annual incidence of CC and LC was 5.0 and 1.7 per 100,000 population, respectively. For coding reasons, it is likely LC data is incomplete. Of 191 cases diagnosed by specialist gastrointestinal pathologists, 141 patients had CC and 50 patients had LC. Both CC and LC predominantly involved females aged 60‐79. Some 15% demonstrated endoscopic abnormalities. Endoscopic sampling protocols varied widely: 30% of CC and 32% of LC cases had right and left colon sampled separately, with histology concordant in 95% of cases. Of the 191 cases, only one case (of LC) was refractory to treatment, the rest exhibiting a clinical response. Only 35 patients had follow up endoscopy and biopsies, and three of each diagnosis showed persistent disease on histology. .

Conclusions
Overall, CC and LC are benign conditions with similar demographics, clinical associations, management and outcomes. Separate sampling of right and left colon is advised at colonoscopy, if this diagnosis is being considered, but left colonic sampling, which can be performed at flexible sigmoidoscopy, will diagnose the vast majority of cases.
Original languageEnglish
JournalColorectal Disease
Early online date09 May 2018
DOIs
Publication statusEarly online date - 09 May 2018

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