P0331 Insights from the Polish Registry of Microscopic Colitis. The Overlapping Symptoms of Microscopic Colitis and Irritable Bowel Syndrome
Year: 2025
Type: conference-abstract
Abstract: Background Microscopic colitis (MC) is a chronic inflammatory bowel disease (IBD), characterized by chronic watery diarrhea without blood, fecal urgency and distninct histological features. Symptoms of MC resemble those of irritable bowel syndrome (IBS), which can delay accurate diagnosis and effective treatment. The potential overlap in symptoms may impede to select effective management strategies. Methods The purpose of establishing the Polish Registry of Microscopic Colitis was to understand the clinical characteristics of patients and to improve diagnosis and treatment effectiveness. We present retrospective and prospective data from the cohort of 213 patients, collected across 9 reference gastroenterology centers in Poland. Results The median age at MC diagnosis was 56 years. MC occurred 3.5 times more frequently in women. On average, patients waited about 3 years for a proper diagnosis after the onset of symptoms. The lymphocytic subtype was diagnosed much more frequently than the collagenous subtype (68.4% vs 23.3%). Predominant symptoms at the diagnosis of MC were watery diarrhea (88.7%) and fecal urgency (68.1%). Patients also reported symptoms more typical of IBS: abdominal pain (59.2%), bloating (60.1%) and incomplete evacuation (40.8%). Notably, one-third of the patients met the Rome IV criteria for IBS during medical interviews (figure 1). Nearly half of the patients had COVID-19 diagnosis confirmed by an authorised test. The most effective treatment was budesonide MMX, with a 93.2% improvement rate. 54% of patients using rifaximin and almost 40% of patients using probiotics reported improvement in intestinal symptoms, although these are not recommended therapies in MC. The effectiveness of various treatments is presented in table 1. Five patients with severe MC were successfully treated with biologics (three with adalimumab and two with vedolizumab). Unfortunately, one patient lost response to adalimumab after 8 months treatment and one patient showed no improvement with adalimumab. Conclusion The similarity of the symptoms of MC and IBS delays an accurate diagnosis. The results from the Polish Microscopic Colitis Registry emphasize a potential overlap of symptoms between MC and IBS. One possible reason for the frequent occurrence of IBS symptoms among patients with MC may be COVID-19 pandemic. The overlap in symptoms, necessitate a comprehensive clinical evaluation to select appropriate treatment and avoid unnecessary escalation of immunosuppressive therapy. The much more frequent diagnosis of the lymphocytic subtype than the collagenous subtype indicates the need for discussion with pathologists about the potential underdiagnosis of collagenous colitis in Poland.
Source: Journal of Crohn s and Colitis
Institutions: National Medical Institute of the Ministry of Interior and Administration, Pomeranian Medical University, Medical University of Lodz, The Maria Sklodowska-Curie National Research Institute of Oncology, Jagiellonian University, University of Wrocław, Wroclaw Medical University, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Medical University of Białystok
Language: English
Topic: Microscopic Colitis
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4406704240