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M
icroscopic
colitis
: A
literature
review
R
ev
A
ssoc
M
ed
B
ras
2016; 62(9):895-900
899
al.,
36
all 25 patients showed improvement after 47 months
of diagnosis, with 29% requiring continuous medication.
F
inal
considerations
MC is a common, relatively new and under-diagnosed
cause of chronic watery diarrhea, which may be confused
with IBS, celiac disease, IBD and other disorders. The peak
incidence occurs in middle-aged women and it is usual-
ly associated with other autoimmune disorders. Diagno-
sis is based on histopathological analysis of colonic mu-
cosal biopsies, which should always be obtained in the
investigation of chronic diarrhea.
The choice of initial drug therapy depends on the in-
tensity of the patient’s symptoms. In patients with mild
symptoms, treatment can be attempted with antidiarrhe-
al medications and bismuth subsalicylate. However, ste-
roid or immunosuppressive drugs are necessary in refrac-
tory cases and those with more intense symptoms, with
budesonide as the drug of choice for short-term treat-
ment. Surgical intervention is the latest treatment option
in cases refractory to all medical therapies. The progno-
sis is good and the disease does not increase the risk of
occurrence of colorectal cancer.
It is necessary to take a multidisciplinary and indi-
vidualized approach, always considering MC as a possi-
ble diagnosis in patients who present chronic diarrhea.
We conclude that there is a need for further random-
ized placebo-controlled studies, especially with regard to
immunomodulators and anti-TNF drugs, as experience
with such is still limited, in order to provide better long-
-term therapeutic strategies and, consequently, better clin-
ical management of the patient.
R
esumo
Colite microscópica: uma revisão da literatura
Colite microscópica (CM) corresponde à inflamação crô-
nica do cólon que se manifesta por modificações histo-
lógicas em nível de uma mucosa radiológica e endosco-
picamente normal. É uma causa comum de diarreia
crônica não sanguinolenta que ocorre principalmente em
indivíduos idosos; porém, há poucos trabalhos na litera-
tura com forte evidência científica quando comparada à
de outras doenças inflamatórias intestinais (DII), o que
limita seu conhecimento por médicos e patologistas. Este
artigo tem como objetivo revisar as informações referen-
tes à CM descrevendo os meios diagnósticos e os medi-
camentos disponíveis para o tratamento. Foi realizada
uma pesquisa na base de dados Pubmed e no Portal da
CAPES entre 1996 e 2015 utilizando as palavras-chave
“colite microscópica”, “colite colagenosa”, “colite linfocí-
tica” e “revisão” para seleção de artigos relacionados ao
tema. Diante dos trabalhos analisados, conclui-se que a
CM é uma desordem gastrointestinal relativamente nova,
a maioria dos estudos são incipientes, principalmente
quanto à imunologia e fisiopatologia, e a budesonida é o
tratamento em curto prazo mais bem documentado. To-
davia são necessários novos estudos para elucidar qual é
a melhor estratégia em longo prazo.
Palavras-chave:
colite microscópica, colite colagenosa,
colite linfocítica, revisão.
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