EC Gastroenterology and Digestive System

Background: Microscopic colitis, a chronic inflammation of the colon characterized by specific histologic changes, normal radiological studies and normal looking colonic mucosa on endoscopy. It is a common cause of chronic non-bloody diarrhea that occurs primarily in older individuals.

Aim of the Study: To evaluate the clinical features, risk factors, endoscopic and histopathology of microscopic colitis in a Sudanese population.

Methods: A retrospective study conducted in Fedail hospital, Khartoum, Sudan. Adult patients diagnosed with microscopic colitis on histopathology between the year 2013 to 2020 were included. Data collected from patient’s medical records attending gastroenterology clinics, endoscopy/histopathology reports and patients were interviewed through phone. The data was analyzed using statistical package for social science SPSS, V. 21.0. IBM; Chicago). P value < 0.05 was considered significant.

Results: Eighty patients with microscopic colitis were enrolled. F\M ratio was 1.3 :1, 58.75% had collagenous variant and 41.25% had lymphocytic variant. Mean age was 43 +/- 14 SD for Lymphocytic Colitis variant and 56 +/- 17 SD for collagenous colitis variant. Common symptoms were chronic watery diarrhea 92.5%, nocturnal diarrhea 67.5%, abdominal pain 50%, fecal incontinence 42.55%, urgency 40%, abdominal distention 15.5%, tenesmus 7.5%, fatigue and arthralgia 15%, weight loss 12.5%. Weight loss was noted in 8 patients (10%) with concomitant celiac disease. Endoscopy normal in 96.25%. Risk factors for MC: use of PPI, 29.25%, NSIADs 18.75%, ACE inhibitors 16.25% and statins 10%. Dairy products were linked to MC in 21.25%, thyroid diseases 10% (those were 8 females with hypothyroidism), celiac disease in 10% and smoking 7.5%. No significant correlations between age, gender and MC variant.

Conclusion: The most common type of MC was the Collagenous variant predominantly among middle aged females. Chronic watery diarrhea was a common symptom of MC. PPI and NSAIDs use were encountered as common risk factors for MC.

Keywords: Microscopic Colitis; Collagenous Variant; Lymphocytic Variant

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