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Microscopic Colitis: What Are The Symptoms, What Is The Treatment And Why Is It Suddenly So Common?

According to Dr George, common symptoms include watery diarrhoea, abdominal pain (cramping or dull), weight loss, fatigue, faecal incontinence, joint or muscle pains, bloating and wind. 

“Fatigue, joint pains and weight loss are not typical symptoms of IBS, but may be symptoms of other types of IBD such as Crohn’s disease or ulcerative colitis,” explains Dr Gill. “Other gut disorders such as coeliac disease and bile acid diarrhoea [urgent, watery, pale stools] are more common in those with microscopic colitis.” 

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How is microscopic colitis diagnosed?

As Dr Gill explained earlier, a diagnosis of microscopic colitis can only be made once a biopsy of the large intestine has been examined under a microscope. In order to perform the biopsy, patients have to have a procedure known as a colonoscopy, which is where a doctor or nurse (an endoscopist) uses a flexible tube with a camera on the end (called a colonoscope) to examine the inside of your large intestine. 

The tube is inserted up your bottom, and although it can be uncomfortable, it’s not usually painful. Once inserted, the endoscopist can take a sample of the tissue (a biopsy), which is then sent to the lab for examination and diagnosis. 

What causes microscopic colitis?

Unfortunately, the causes of microscopic colitis are not properly understood. “The short answer is we don’t really know,” says Dr Gill. “It’s thought to be a combination of factors that trigger your immune system to go into overdrive and start attacking the healthy cells that line the large intestine.”

However, there are some risk factors that could increase your chance of having it. “More research is needed but risk factors are thought to be increasing age – most common between the ages of 50-70 years, sex – women are more affected than me and cigarette smoking,” explains Dr George. 

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Why is it suddenly affecting so many women?

While it may seem that more people are being diagnoses with microscopic colitis, it’s more likely that the condition is simply getting more attention on social media, especially TikTok, due to women sharing their experiences and stories of diagnosis in order to help others suffering from similar symptoms. 

“Thankfully, in recent years, there has been far more openness and awareness on social media around breaking the poo taboo, stimulating dialogue and breaking the stigma around gut issues,” says Dr Gill. “I mean, we all go to the toilet, most of us have experienced a bout of diarrhoea or constipation at some point, and so many people are troubled with gut disorders, so we should be talking about it. People are more conscious of their gut health than ever before, and information about what to do if you are experiencing symptoms is more accessible, so it’s moving in the right direction.”

What is the treatment for microscopic colitis? 

“Treatment for microscopic colitis should always be done in conjunction with a registered healthcare professional. It is important that all the relevant investigations have been carried out before embarking on treatment,” warns Dr George. “Treatment varies depending on the severity of symptoms and ranges from lifestyle changes to prescription medications.”

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