Microscopic Colitis

Chronic inflammatory colon disease detected histologically in mucosa that appears normal at colonoscopy.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 9, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Microscopic Colitis?

Microscopic colitis is an inflammatory bowel disease presenting with chronic watery diarrhea, detected histopathologically in mucosa that appears macroscopically normal at colonoscopy. There are two main subtypes: lymphocytic colitis and collagenous colitis.

It is more common in middle-aged and elderly women. Drugs (NSAIDs, PPIs, SSRIs), autoimmune diseases (celiac, rheumatoid arthritis), smoking, and bile acid malabsorption play roles in the etiology.

Multiple biopsies taken during colonoscopy are essential for diagnosis. Lymphocytic colitis shows increased intraepithelial lymphocytes, while collagenous colitis shows thickening of the subepithelial collagen band.

Symptoms

Chronic, watery, non-bloody diarrhea (4-10 times/day)

Diarrhea that wakes one at night

Accompanying abdominal cramps

Mild weight loss

Fecal urgency and incontinence

Nausea and bloating

Arthralgia and fatigue

Risk Factors

Female sex and being over 50

Long-term use of PPIs, NSAIDs, or SSRIs

Smoking

Celiac disease and autoimmune diseases

Thyroid diseases

Bile acid malabsorption

Family history of bowel disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

Watery diarrhea lasting more than 4 weeks
If there is diarrhea that wakes one at night
If accompanied by weight loss
Suspicion of drug-related diarrhea
If standard antidiarrheal treatment is unresponsive

Treatment Methods

Budesonide (first choice; both induction and maintenance)

Discontinuation of suspected drugs (NSAIDs, PPIs)

Smoking cessation

Cholestyramine (if bile acid malabsorption)

Biological therapies in resistant cases (anti-TNF, vedolizumab)

Avoidance of lactose, caffeine, and artificial sweeteners

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.