P009 The value of random mucosal biopsies in the diagnosis of microscopic colitis
Published Date: 16th September 2020
Publication Authors: Brice R
Introduction
The incidence of microscopic colitis (MC) has recently increased to that of ulcerative colitis and Crohn's disease but its diagnosis can be difficult.
Aim
To establish the incidence of MC and the diagnostic value of random mucosal biopsies.
Method
100 consecutive patients (35 men and 65 women; median age 58.5 years, ranging from 19 to 93 years) suffering with a variety of complaints but the predominant symptom of diarrhoea underwent lower intestinal endoscopy and were included into the study. In all patients, the procedure (colonoscopy in 69 and flexible sigmoidoscopy in 31) revealed no endoscopic features of mucosal inflammation. Findings on histological examination of random mucosal biopsies were retrospectively analysed.
Results
Biopsies revealed MC in 9 patients. One‐third (3 patients) and two‐thirds (6 patients) had lymphocytic and collagenous colitis respectively in biopsies from both sides of the colon with collagenous colitis being more severe in the right colon.
Conclusion
In patients with chronic diarrhoea and endoscopically normal mucosal appearances, biopsies offer high yield (9%) in the diagnosis of MC. Flexible sigmoidoscopy and left‐sided biopsies alone are insufficient. The diagnosis of collagenous colitis can often be established only by right‐sided mucosal biopsies making colonoscopy the investigation of obvious choice.
Manoharan, K; Brice, R et al. (2020). P009 The value of random mucosal biopsies in the diagnosis of microscopic colitis. Colorectal Disease. 22 (S3), 10.