Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year
Background and Aims: Microscopic colitis (MC) is a common cause of chronic diarrhea; however, the clinical course of this disease is poorly understood. We aimed to investigate how patients diagnosed with MC were treated in routine clinical practice and how their symptoms compared to patients with ot...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572323001966 |
| _version_ | 1797202995740409856 |
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| author | Walker D. Redd Chelsea Anderson Anne F. Peery Temitope O. Keku John T. Woosley Robert S. Sandler |
| author_facet | Walker D. Redd Chelsea Anderson Anne F. Peery Temitope O. Keku John T. Woosley Robert S. Sandler |
| author_sort | Walker D. Redd |
| collection | DOAJ |
| description | Background and Aims: Microscopic colitis (MC) is a common cause of chronic diarrhea; however, the clinical course of this disease is poorly understood. We aimed to investigate how patients diagnosed with MC were treated in routine clinical practice and how their symptoms compared to patients with other causes of chronic diarrhea at one year follow-up. Methods: We conducted a case-control study of patients undergoing outpatient colonoscopy to evaluate diarrhea. The study pathologist determined whether patients were classified as MC cases or non-MC controls. One year after colonoscopy, we interviewed cases (n = 74) and controls (n = 162) about their diagnosis, medications for diarrhea, and symptom burden. Results: At 1-year follow-up after colonoscopy, 10% of MC cases were unaware of the diagnosis, 60% had been prescribed a medication for diarrhea, 40% had fecal urgency, 32% had weight loss, and 21% had fecal incontinence. Among cases, 46% were treated with budesonide. Compared to cases, controls had worse symptoms based on the Microscopic Colitis Disease Activity Index score with a median score of 3.0 (interquartile range 1.9–4.2) vs 2.3 (interquartile range 1.4–3.2) at 1-year follow-up. Controls had more frequent stools, urgency, fecal incontinence, and abdominal pain. Conclusion: In a cohort of patients with biopsy-confirmed MC and diarrhea controls, we found that some cases remained unaware of their diagnosis, many cases had persistent symptoms, and controls had worse symptoms than cases. These findings suggest there are opportunities to improve management of this chronic disease. |
| first_indexed | 2024-03-07T15:45:58Z |
| format | Article |
| id | doaj.art-e0dcc02792dc4b4fbcbdfb9cd537c41f |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-04-24T08:12:18Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-e0dcc02792dc4b4fbcbdfb9cd537c41f2024-04-17T04:50:17ZengElsevierGastro Hep Advances2772-57232024-01-0133336343Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 YearWalker D. Redd0Chelsea Anderson1Anne F. Peery2Temitope O. Keku3John T. Woosley4Robert S. Sandler5Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Correspondence: Address correspondence to: Walker D. Redd, MD, Department of Medicine, University of North Carolina, 4119B Bioinformatics Building, 130 Mason Farm Rd., Chapel Hill, North Carolina 27599-7080.Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaUNC Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Gastrointestinal Biology and Disease, University of North Carolina at Chapel Hill, Chapel Hill, North CarolinaBackground and Aims: Microscopic colitis (MC) is a common cause of chronic diarrhea; however, the clinical course of this disease is poorly understood. We aimed to investigate how patients diagnosed with MC were treated in routine clinical practice and how their symptoms compared to patients with other causes of chronic diarrhea at one year follow-up. Methods: We conducted a case-control study of patients undergoing outpatient colonoscopy to evaluate diarrhea. The study pathologist determined whether patients were classified as MC cases or non-MC controls. One year after colonoscopy, we interviewed cases (n = 74) and controls (n = 162) about their diagnosis, medications for diarrhea, and symptom burden. Results: At 1-year follow-up after colonoscopy, 10% of MC cases were unaware of the diagnosis, 60% had been prescribed a medication for diarrhea, 40% had fecal urgency, 32% had weight loss, and 21% had fecal incontinence. Among cases, 46% were treated with budesonide. Compared to cases, controls had worse symptoms based on the Microscopic Colitis Disease Activity Index score with a median score of 3.0 (interquartile range 1.9–4.2) vs 2.3 (interquartile range 1.4–3.2) at 1-year follow-up. Controls had more frequent stools, urgency, fecal incontinence, and abdominal pain. Conclusion: In a cohort of patients with biopsy-confirmed MC and diarrhea controls, we found that some cases remained unaware of their diagnosis, many cases had persistent symptoms, and controls had worse symptoms than cases. These findings suggest there are opportunities to improve management of this chronic disease.http://www.sciencedirect.com/science/article/pii/S2772572323001966DiarrheaMicroscopic ColitisColonoscopyCommunication |
| spellingShingle | Walker D. Redd Chelsea Anderson Anne F. Peery Temitope O. Keku John T. Woosley Robert S. Sandler Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year Gastro Hep Advances Diarrhea Microscopic Colitis Colonoscopy Communication |
| title | Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year |
| title_full | Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year |
| title_fullStr | Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year |
| title_full_unstemmed | Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year |
| title_short | Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year |
| title_sort | follow up of microscopic colitis patients and diarrhea controls at 1 year |
| topic | Diarrhea Microscopic Colitis Colonoscopy Communication |
| url | http://www.sciencedirect.com/science/article/pii/S2772572323001966 |
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