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Abstract：
OBJECTIVE: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：显微镜下结肠炎（MC）是慢性腹泻的常见原因；这种疾病的临床过程知之甚少。我们旨在调查在常规临床实践中如何治疗被诊断为MC的患者，以及在一年的随访中，与其他慢性腹泻原因的患者相比，他们的症状如何。
方法：我们对接受门诊结肠镜检查的患者进行了病例对照研究，以评估腹泻。研究病理学家确定患者是否被分类为MC病例或非MC对照。结肠镜检查一年后，我们采访了有关其诊断的病例（n=74）和对照（n=162），治疗腹泻的药物，和症状负担。
结果：结肠镜检查后1年随访，10%的MC病例不知道诊断，60%的人被开了治疗腹泻的药,40%有粪便急迫感,32%的人体重减轻,21%有大便失禁。在案件中，46%用布地奈德治疗。与案例相比，根据显微镜下结肠炎疾病活动指数评分,在1年随访时,对照组症状更差,中位评分为3.0分(四分位距1.9-4.2分)vs2.3分(四分位距1.4-3.2分).对照组有更频繁的大便，紧迫性,大便失禁,和腹痛。
结论：在一组活检证实为MC和腹泻对照的患者中，我们发现一些病例仍然不知道他们的诊断，许多病例有持续的症状，和对照组的症状比病例更糟糕。这些发现表明，有机会改善这种慢性疾病的管理。
方法：我们对接受门诊结肠镜检查的患者进行了病例对照研究，以评估腹泻。研究病理学家确定患者是否被分类为MC病例或非MC对照。结肠镜检查一年后，我们采访了有关其诊断的病例（n=74）和对照（n=162），治疗腹泻的药物，和症状负担。
结果：结肠镜检查后1年随访，10%的MC病例不知道诊断，60%的人被开了治疗腹泻的药,40%有粪便急迫感,32%的人体重减轻,21%有大便失禁。在案件中，46%用布地奈德治疗。与案例相比，根据显微镜下结肠炎疾病活动指数评分,在1年随访时,对照组症状更差,中位评分为3.0分(四分位距1.9-4.2分)vs2.3分(四分位距1.4-3.2分).对照组有更频繁的大便，紧迫性,大便失禁,和腹痛。
结论：在一组活检证实为MC和腹泻对照的患者中，我们发现一些病例仍然不知道他们的诊断，许多病例有持续的症状，和对照组的症状比病例更糟糕。这些发现表明，有机会改善这种慢性疾病的管理。
