P240 Microscopic colitis, are there any predictors?
I. G. Moraru*1, R. Vadan1, L. Gheorghe2, M. Dumbrava3, G. Becheanu3
1Third Department of Gastroenterology, Clinical Hospital Fundeni, Bucarest, Gastroenterology, Bucarest, Romania, 2Third Department of Gastroenterology, Clinical Hospital Fundeni, Bucarest, Hepatology, Bucarest, Romania, 3Third Department of Gastroenterology, Clinical Hospital Fundeni, Bucarest, Anatomical Pathology, Bucarest, Romania
Irritable bowel syndrome (IBS) is one of the most common disorders diagnosed all over the world. Symptoms of IBS predominant diarrhoea (IBS-D) and microscopic colitis (MC) overlap in a large degree. MC is defined as a clinical syndrome, consisting of chronic diarrhoea, with normal large bowel appearance at endoscopic and radiologic evaluation and typical histological findings. Two disorders, lymphocytic and collagenous colitis, are grouped under the term MC. The aim of our study was to evaluate the prevalence of MC in IBS-D patients and to analyse demographic, clinical, laboratory, and endoscopic aspects of patients with MC.
We performed a 4-year retrospective study (2011–2014) on 109 patients diagnosed with IBS-D according to Rome III criteria. Comorbidities were noted. The abnormal blood tests results were also recorded; all patients included in the study had normal abdominal ultrasound, normal upper endoscopy, and normal colonoscopy. Multiple biopsies were taken during colonoscopy (from all colonic segments). The diagnosis of MC was established based on classic criteria; demographic, clinical, laboratory aspects, and associated diseases of MC patients were compared with those of IBS-D patients using EpiInfo 2008.
In total, 109 IBS-D patients with normal colonoscopy were included in the study. MC was observed in 18 patients, 16 females (88.8%) and 2 males (11.1%), mean age 58.6 years. MC was more frequent in older patients than IBS-D (mean age 57.7 vs 46.6) and was associated with the presence of autoimmune thyroiditis (p = 0.0003), diverticulosis (p = 0.001), hypertension (p = 0.0009), and anaemia (p = 0.01). There were no statistical differences (p > 0.05) between MC patients and IBS-D regarding the presence of type II diabetes, hepatic steatosis, hypercholesterolemia, celiac disease, and cholecystectomy.
MC is an infrequent cause of chronic diarrhoea and should be suspected especially in older female patients with concomitant autoimmune disorders. When other causes of diarrhoea like IBS-D are ruled out, a colonoscopy with random biopsies from all regions of allows for the diagnosis of MC.