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Microscopic Colitis

Microscopic colitis describes two different conditions that cause chronic diarrhea: lymphocytic and collagenous colitis. Both types are diagnosed and treated in the same way. The specific cause of microscopic colitis is often difficult to determine. It may be related to autoimmune conditions such as celiac disease, arthritis and diabetes or a result of a past bacterial or viral infection. The use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen has also been reported as a possible cause of inducing microscopic colitis. 

Microscopic colitis frequently develops in women over the age of 60. Although a benign illness, microscopic colitis can lead to symptoms that may diminish the quality of life of individuals suffering from the condition.

Microscopic Colitis Symptoms and Diagnosis

Microscopic colitis causes chronic or intermittent non-bloody, watery diarrhea. Some people experiencing severe diarrhea may have more than 10 bowel movements a day. Other microscopic colitis symptoms include:

  • nocturnal diarrhea
  • incontinence
  • urgency
  • abdominal pain
  • weight loss

It is important to see an IBD physician to carefully review your medical history, record of recent infections and medication usage. Other causes of diarrhea and symptoms similar to microscopic colitis may be found after careful evaluation of this information.

Your physician may recommend a colonoscopy to further evaluate the cause of your diarrhea. During the procedure, biopsies are taken and examined for any signs of inflammation in the lining of your colon. Biopsies will confirm the diagnosis of microscopic colitis.

Microscopic Colitis Treatment

The therapies available for microscopic colitis often lead to satisfactory control of the disease. Your NorthShore gastroenterologist will develop a personalized microscopic colitis treatment plan for you, tailored to the severity of your symptoms. Recommended treatment may include avoiding dietary intolerances or any potential causes of diarrhea and/or over-the-counter anti-diarrheal therapies.


Medications used for microscopic colitis treatment include:

  • Loperamide or other over-the-counter anti-diarrheals: For mild cases, symptoms of diarrhea are often adequately managed by over-the-counter anti-diarrheals, which are often tried first in the management of symptoms.
  • Cholestyramine: This is a medication usually used to treat high cholesterol but helps to bind your body’s bile acids, which can sometimes cause diarrhea in patients with microscopic colitis.
  • Corticosteroids: These medications are often released locally in the bowel to address inflammation on the surface of the colon. One steroid medication, budesonide, has been shown to be very effective in patients with microscopic colitis.


Surgery to create an ostomy or remove parts of the colon is another option for treating microscopic colitis. It is very rarely recommended and reserved for the most persistent, untreatable cases of the disease.

Innovative Research for Microscopic Colitis

NorthShore has the unique distinction of housing one of the premier active research programs focused on microscopic colitis. Through dedicated research efforts, our clinical investigators have taken the lead in better understanding the disease to improve diagnosis and microscopic colitis treatment options.

We are also the only institution in the nation with a microscopic colitis disease registry, where patients have volunteered their clinical information and tissue samples to allow researchers to better understand the genetics and natural history of microscopic colitis. This important work has been presented at national and international scientific meetings, and published in prestigious journals in the field, distinguishing our IBD center as a leader in microscopic colitis research.

Our clinical trials focus on several aspects of microscopic colitis, including the influence of lifestyle factors and medication; associations with other disorders such as colon cancer and celiac disease; and quality of life.

For More Information

For more information on microscopic colitis symptoms and treatment, or to schedule an appointment with an IBD physician, please call 847.570.2903.