Epidemiology, clinical presentation, associated factors, and current trends in microscopic colitis

Abstract

Microscopic colitis has attracted the attention of internists and gastroenterologists due to its increasing incidence and the gaps in knowledge about the disease. Like other inflammatory bowel diseases, microscopic colitis frequently manifests as watery diarrhea, particularly in older patients, and significantly reduces their quality of life. This review aims to analyze the current understanding of microscopic colitis based on published studies. A literature search was conducted in PubMed and eLibrary.Ru (1976–2024) databases using the keywords microscopic colitis and микроскопический колит. Epidemiological data indicate an increasing incidence of microscopic colitis with global prevalence variability. The present study examines risk factors for microscopic colitis, including gut microbiota alterations, genetic determinants, and infectious factors, as well as the association of the disease with COVID-19. Significant risk factors for microscopic colitis include smoking and certain medications. The review discusses sex- and age-related characteristics of microscopic colitis, as well as the differentiation between collagenous and lymphocytic subtypes. According to most studies, the risk of developing microscopic colitis is associated with female sex and older age. The prevalence of collagenous colitis is notably higher among women than among men. The histological criteria, clinical presentation, and differential diagnosis of microscopic colitis are outlined, along with diagnostic criteria for incomplete forms of the disease. In addition, the study discusses non-invasive biomarkers of microscopic colitis and its associations with diseases of other systems, including autoimmune and cardiovascular conditions. Of particular interest is the frequent coexistence of microscopic colitis and celiac disease. Gaps in the knowledge of microscopic colitis are analyzed, and the issues of disease management, including achieving and maintaining clinical remission, are addressed. This review summarizes current evidence on microscopic colitis as a cause of unexplained watery diarrhea, particularly in older patients, including those in countries with low reported disease prevalence.

Keywords

microscopic colitis / collagenous colitis / lymphocytic colitis / diagnosis / epidemiology / therapy

References

[1] Nielsen OH, Fernandez-Banares F, Sato T, Pardi DS. Microscopic colitis: Etiopathology, diagnosis, and rational management. Elife. 2022;11:e79397. doi: 10.7554/eLife.79397

[2] Marlicz W., Skonieczna-Żydecka K., Yung D.E., et al. Endoscopic findings and colonic perforation in microscopic colitis: A systematic review. // Digestive and Liver Disease. 2004. Vol. 49. P. 1073–1085. doi: 10.1016/j.dld.2017.07.015

[3] Marlicz W, Skonieczna-Żydecka K, Yung DE, et al. Endoscopic findings and colonic perforation in microscopic colitis: A systematic review. Digestive and Liver Disease. 2004;49:1073–1085. doi: 10.1016/j.dld.2017.07.015

[4] Nielsen O.H., Fernandez-Banares F., Sato T., Pardi D.S. Microscopic colitis: Etiopathology, diagnosis, and rational management // Elife. 2022. Vol. 11. P. e79397. doi: 10.7554/eLife.79397

[5] Freeman HJ, Weinstein WM, Shnitka TK, et al. Watery diarrhea syndrome associated with a lesion of the colonic basement membrane-lamina propria interface. Ann Royal Coll Phys Surg Canada. 1976;9:45. doi: 10.22037/ghfbb.v16i2.2698

[6] Freeman H.J., Weinstein W.M., Shnitka T.K., et al. Watery diarrhea syndrome associated with a lesion of the colonic basement membrane-lamina propria interface // Ann Royal Coll Phys Surg Canada. 1976. Vol. 9. P. 45. doi: 10.22037/ghfbb.v16i2.2698

[7] Lindstrom CG. Collagenous colitis with watery diarrhea — a new entity? Pathol Eur. 1976;11:87–89

[8] Lindstrom C.G. Collagenous colitis with watery diarrhea — a new entity? // Pathol Eur. 1976. Vol. 11. P. 87–89.

[9] Freeman HJ. Collagenous colitis associated with novel sprue-like intestinal diseases. Gastroenterol Hepatol Bed Bench. 2023;16(2):145–150. doi: 10.22037/ghfbb.v16i2.2698

[10] Freeman H.J. Collagenous colitis associated with novel sprue-like intestinal diseases // Gastroenterol Hepatol Bed Bench. 2023. Vol. 16, N. 2. P. 145–150. doi: 10.22037/ghfbb.v16i2.2698

[11] Stahl E, Roda G, Dobbyn A, et al. Collagenous Colitis Is Associated With HLA Signature and Shares Genetic Risks with Other Immune-Mediated Diseases. Gastroenterology. 2020;159(2):549–561.e8. doi: 10.1053/j.gastro.2020.04.063

[12] Stahl E., Roda G., Dobbyn A., et al. Collagenous Colitis Is Associated with HLA Signature and Shares Genetic Risks with Other Immune-Mediated Diseases // Gastroenterology. 2020. Vol. 159, N. 2. P. 549–561.e8. doi: 10.1053/j.gastro.2020.04.063

[13] Burke KE, D’Amato M, Ng SC, et al. Microscopic colitis. Nat Rev Dis Primers. 2021;7(1):39. doi: 10.1038/s41572-021-00273-2

[14] Burke K.E., D’Amato M., Ng S.C., et al. Microscopic colitis // Nat Rev Dis Primers. 2021. Vol. 7, N. 1. P. 39. doi: 10.1038/s41572-021-00273-2

[15] Bergman D, Khalili H, Lebwohl B, et al. Celiac disease and risk of microscopic colitis: A nationwide population-based matched cohort study. United European Gastroenterol J. 2023;11(2):189–201. doi: 10.1002/ueg2.12374

[16] Bergman D., Khalili H., Lebwohl B., et al. Celiac disease and risk of microscopic colitis: A nationwide population-based matched cohort study // United European Gastroenterol J. 2023. Vol. 11, N. 2. P. 189–201. doi: 10.1002/ueg2.12374

[17] Green PH, Yang J, Cheng J, et al. An association between microscopic colitis and celiac disease. Clin Gastroenterol Hepatol. 2009;7(11):1210–6. doi: 10.1016/j.cgh.2009.07.011

[18] Green P.H., Yang J., Cheng J., et al. An association between microscopic colitis and celiac disease // Clin Gastroenterol Hepatol. 2009. Vol. 7, N. 11. P. 1210–6. doi: 10.1016/j.cgh.2009.07.011

[19] Roth B, Ohlsson B. Microscopic colitis found together with celiac disease in a female population is associated with one episode of lymphocytic colitis. BMC Gastroenterol. 2024;24(1):70. doi: 10.1186/s12876-024-03158-2

[20] Roth B., Ohlsson B. Microscopic colitis found together with celiac disease in a female population is associated with one episode of lymphocytic colitis // BMC Gastroenterol. 2024. Vol. 24, N. 1. P. 70. doi: 10.1186/s12876-024-03158-2

[21] Nimri FM, Muhanna A, Almomani Z, et al. The association between microscopic colitis and celiac disease; a systematic review and meta-analysis. Ann Gastroenterol. 2022;35:281–289. doi: 10.20524/aog.2022.0714

[22] Nimri F.M., Muhanna A., Almomani Z., et al. The association between microscopic colitis and celiac disease; a systematic review and meta-analysis // Ann Gastroenterol. 2022. Vol. 35. P. 281–289. doi: 10.20524/aog.2022.0714

[23] Altawili A, Albalawi MA, Albalawi SA, et al. Exploring the association between microscopic colitis and celiac disease: A comprehensive analysis using the national in-patient data (2016–2019). Saudi J Gastroenterol. 2024;30(5):319–323. doi: 10.4103/sjg.sjg_92_24

[24] Altawili A., Albalawi M.A., Albalawi S.A., et al. Exploring the association between microscopic colitis and celiac disease: A comprehensive analysis using the national in-patient data (2016–2019) // Saudi J Gastroenterol. 2024. Vol. 30, N. 5. P. 319–323. doi: 10.4103/sjg.sjg_92_24

[25] Yuan L, Wu TT, Zhang L. Microscopic colitis: lymphocytic colitis, collagenous colitis, and beyond. Hum Pathol. 2023;132:89–101. doi: 10.1016/j.humpath.2022.06.027

[26] Yuan L., Wu T.T., Zhang L. Microscopic colitis: lymphocytic colitis, collagenous colitis, and beyond // Hum Pathol. 2023. Vol. 132. P. 89–101. doi: 10.1016/j.humpath.2022.06.027

[27] Pervez A, Siddique K, Khan MAS. A Literature Review of Microscopic Colitis. Cureus. 2024;16(1):e52862. doi: 10.7759/cureus.52862

[28] Pervez A., Siddique K., Khan M.A.S. A Literature Review of Microscopic Colitis // Cureus. 2024. Vol. 16, N. 1. P. e52862. doi: 10.7759/cureus.52862

[29] Langner C, Aust D, Ensari A, et al. Histology of microscopic colitis-review with a practical approach for pathologists. Histopathology. 2015;66(5):613–26. doi: 10.1111/his.12592

[30] Langner C., Aust D., Ensari A., et al. Histology of microscopic colitis-review with a practical approach for pathologists // Histopathology. 2015. Vol. 66, N. 5. P. 613–26. doi: 10.1111/his.12592

[31] Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations. United Eur Gastroenterol J. 2021;9:13–37. doi: 10.1177/2050640620951905

[32] Miehlke S., Guagnozzi D., Zabana Y., et al. European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations // United Eur Gastroenterol J. 2021. Vol. 9. P. 13–37. doi: 10.1177/2050640620951905

[33] Mahajan D, Goldblum JR, Xiao S.Y, et al. Lymphocytic colitis and collagenous colitis: a review of clinicopathologic features and immunologic abnormalities. Adv Anat Pathol. 2012;19(1):28–38. doi: 10.1097/PAP.0b013e31823d7705

[34] Mahajan D., Goldblum J.R., Xiao S.Y., et al. Lymphocytic colitis and collagenous colitis: a review of clinicopathologic features and immunologic abnormalities // Adv Anat Pathol. 2012. Vol. 19, N. 1. P. 28–38. doi: 10.1097/PAP.0b013e31823d7705

[35] Bhardwaj A, Münch A, Montague J, et al. Lymphocytic colitis can be transcriptionally divided into channelopathic and inflammatory lymphocytic colitis. United European Gastroenterol J. 2024;12(6):737–748. doi: 10.1002/ueg2.12531

[36] Bhardwaj A., Münch A., Montague J., et al. Lymphocytic colitis can be transcriptionally divided into channelopathic and inflammatory lymphocytic colitis // United European Gastroenterol J. 2024. Vol. 12, N. 6. P. 737–748. doi: 10.1002/ueg2.12531

[37] Mori H, Miyake T, Shimizu T, et al. A case of spontaneous colonic perforation in collagenous colitis. Surg Case Rep. 2019;5(1):90. doi: 10.1186/s40792-019-0647-0

[38] Mori H., Miyake T., Shimizu T., et al. A case of spontaneous colonic perforation in collagenous colitis // Surg Case Rep. 2019. Vol. 5, N. 1. P. 90. doi: 10.1186/s40792-019-0647-0

[39] Chetty R, Govender D. Lymphocytic and collagenous colitis: an overview of so-called microscopic colitis. Nat Rev Gastroenterol Hepatol. 2012;9(4):209–18. doi: 10.1038/nrgastro.2012.16

[40] Chetty R., Govender D. Lymphocytic and collagenous colitis: an overview of so-called microscopic colitis // Nat Rev Gastroenterol Hepatol. 2012. Vol. 9, N. 4. P. 209–18. doi: 10.1038/nrgastro.2012.16

[41] Magro F, Langner C, Driessen A, et al. European consensus on the histopathology of inflammatory bowel disease. J Crohns Colitis. 2013;7(10):827–51. doi: 10.1016/j.crohns.2013.06.001

[42] Magro F., Langner C., Driessen A., et al; European Society of Pathology (ESP); European Crohn’s and Colitis Organisation (ECCO). European consensus on the histopathology of inflammatory bowel disease // J Crohns Colitis. 2013. Vol. 7, N. 10. P. 827–51. doi: 10.1016/j.crohns.2013.06.001

[43] Mogilnaya GM, Durleshter VM, Mogilnaya VL, et al. Microscopic colitis. Commonalities and Differences. Kuban Scientific Medical Bulletin. 2019;26(5):65–76. doi: 10.25207/1608-6228-2019-26-5-65-76

[44] Могильная Г.М., Дурлештер В.М., Могильная В.Л., и др. Микроскопические колиты. Общность и различия // Кубанский научный медицинский вестник. 2019. Т. 26, № 5. С. 65–76. doi: 10.25207/1608-6228-2019-26-5-65-76

[45] Fiehn AK, Engel PJH, Engel U, et al. Number of intraepithelial lymphocytes and presence of a subepithelial band in normal colonic mucosa differs according to stainings and evaluation method. J Pathol Inform. 2024;15:100374. doi: 10.1016/j.jpi.2024.100374

[46] Fiehn A.K., Engel P.J.H., Engel U., et al. Number of intraepithelial lymphocytes and presence of a subepithelial band in normal colonic mucosa differs according to stainings and evaluation method // J Pathol Inform. 2024. Vol. 15. P. 100374. doi: 10.1016/j.jpi.2024.100374

[47] Bergman D, Clements MS, Khalili H, et al. A nationwide cohort study of the incidence of microscopic colitis in Sweden. Aliment Pharmacol Ther. 2019;49(11):1395–400. doi: 10.1111/apt.152469

[48] Bergman D., Clements M.S., Khalili H., et al. A nationwide cohort study of the incidence of microscopic colitis in Sweden // Aliment Pharmacol Ther. 2019. Vol. 49, N. 11. P. 1395–400. doi: 10.1111/apt.152469

[49] Weimers P, Vedel Ankersen D, Lophaven S, et al. Disease Activity Patterns, Mortality, and Colorectal Cancer Risk in Microscopic Colitis: A Danish Nationwide Cohort Study, 2001 to 2016. J Crohns Colitis. 2021;15(4):594–602. doi: 10.1093/ecco-jcc/jjaa207

[50] Weimers P., Vedel Ankersen D., Lophaven S., et al. Disease Activity Patterns, Mortality, and Colorectal Cancer Risk in Microscopic Colitis: A Danish Nationwide Cohort Study, 2001 to 2016 // J Crohns Colitis. 2021. Vol. 15, N. 4. P. 594–602. doi: 10.1093/ecco-jcc/jjaa207

[51] Lophaven SN, Lynge E, Burisch J. The incidence of inflammatory bowel disease in Denmark 1980–2013: a nationwide cohort study. Aliment Pharmacol Ther. 2017;45(7):961–972. doi: 10.1111/apt.13971

[52] Lophaven S.N., Lynge E., Burisch J. The incidence of inflammatory bowel disease in Denmark 1980–2013: a nationwide cohort study // Aliment Pharmacol Ther. 2017. Vol. 45, N. 7. P. 961–972. doi: 10.1111/apt.13971

[53] Verhaegh BP, Jonkers DM, Driessen A, et al. Incidence of microscopic colitis in the Netherlands. A nationwide population-based study from 2000 to 2012. Dig Liver Dis. 2015;47(1):30–6. doi: 10.1016/j.dld.2014.09.019

[54] Verhaegh B.P., Jonkers D.M., Driessen A., et al. Incidence of microscopic colitis in the Netherlands. A nationwide population-based study from 2000 to 2012 // Dig Liver Dis. 2015. Vol. 47, N. 1. P. 30–6. doi: 10.1016/j.dld.2014.09.019

[55] Fernández-Bañares F, Zabana Y, Aceituno M, et al. Prevalence and Natural History of Microscopic Colitis: A Population-Based Study with Long-term Clinical Follow-up in Terrassa, Spain. J Crohns Colitis. 2016;10(7):805–11. doi: 10.1093/ecco-jcc/jjw037

[56] Fernández-Bañares F., Zabana Y., Aceituno M., et al. Prevalence and Natural History of Microscopic Colitis: A Population-Based Study with Long-term Clinical Follow-up in Terrassa, Spain // J Crohns Colitis. 2016. Vol. 10, N. 7. P. 805–11. doi: 10.1093/ecco-jcc/jjw037

[57] Vigren L, Olesen M, Benoni C, Sjöberg K. An epidemiological study of collagenous colitis in southern Sweden from 2001–2010. World J Gastroenterol. 2012;18(22):2821–6. doi: 10.3748/wjg.v18.i22.2821

[58] Vigren L., Olesen M., Benoni C., Sjöberg K. An epidemiological study of collagenous colitis in southern Sweden from 2001–2010 // World J Gastroenterol. 2012. Vol. 18, N. 22. P. 2821–6. doi: 10.3748/wjg.v18.i22.2821

[59] El-Matary W, Girgis S, Huynh H, et al. Microscopic colitis in children. Dig Dis Sci. 2010;55(7):1996–2001. doi: 10.1007/s10620-009-0964-44

[60] El-Matary W., Girgis S., Huynh H., et al. Microscopic colitis in children // Dig Dis Sci. 2010. Vol. 55, N. 7. P. 1996–2001. doi:10.1007/s10620-009-0964-4

[61] Larsson JK, Sonestedt E, Ohlsson B, et al. The association between the intake of specific dietary components and lifestyle factors and microscopic colitis. Eur J Clin Nutr. 2016;70(11):1309–1317. doi: 10.1038/ejcn.2016.130

[62] Larsson J.K., Sonestedt E., Ohlsson B., et al. The association between the intake of specific dietary components and lifestyle factors and microscopic colitis // Eur J Clin Nutr. 2016. Vol. 70, N. 11. P. 1309–1317. doi: 10.1038/ejcn.2016.130

[63] Burke KE, Ananthakrishnan AN, Lochhead P, et al. Smoking is Associated with an Increased Risk of Microscopic Colitis: Results From Two Large Prospective Cohort Studies of US Women. J Crohns Colitis. 2018;12(5):559–567. doi: 10.1093/ecco-jcc/jjy005

[64] Burke K.E., Ananthakrishnan A.N., Lochhead P., et al. Smoking is Associated with an Increased Risk of Microscopic Colitis: Results from Two Large Prospective Cohort Studies of US Women // J Crohns Colitis. 2018. Vol. 12, N. 5. P. 559–567. doi: 10.1093/ecco-jcc/jjy005

[65] Jaruvongvanich V, Poonsombudlert K, Ungprasert P. Smoking and Risk of Microscopic Colitis: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. 2019;25(4):672–678. doi: 10.1093/ibd/izy296

[66] Jaruvongvanich V., Poonsombudlert K., Ungprasert P. Smoking and Risk of Microscopic Colitis: A Systematic Review and Meta-analysis // Inflamm Bowel Dis. 2019. Vol. 25, N. 4. P. 672–678. doi: 10.1093/ibd/izy296

[67] Al Momani L, Balagoni H, Alomari M, et al. The association between smoking and both types of microscopic colitis: A systematic review and meta-analysis. Arab J Gastroenterol. 2020;21(1):9–18. doi: 10.1016/j.ajg.2020.01.004

[68] Al Momani L., Balagoni H., Alomari M., et al. The association between smoking and both types of microscopic colitis: A systematic review and meta-analysis // Arab J Gastroenterol. 2020. Vol. 21, N. 1. P. 9–18. doi: 10.1016/j.ajg.2020.01.004

[69] Khalili H, Axelrad JE, Roelstraete B, et al. Gastrointestinal Infection and Risk of Microscopic Colitis: A Nationwide Case-Control Study in Sweden. Gastroenterology. 2021;160(5):1599–1607.e5. doi: 10.1053/j.gastro.2021.01.004

[70] Khalili H., Axelrad J.E., Roelstraete B., et al. Gastrointestinal Infection and Risk of Microscopic Colitis: A Nationwide Case-Control Study in Sweden // Gastroenterology. 2021. Vol. 160, N. 5. P. 1599–1607.e5. doi: 10.1053/j.gastro.2021.01.004

[71] Khalili H, Zheng T, Söderling J, et al. Association Between Collagenous and Lymphocytic Colitis and Risk of Severe Coronavirus Disease 2019. Gastroenterology. 2021;160(7):2585–2587.e3. doi: 10.1053/j.gastro.2021.02.029

[72] Khalili H., Zheng T., Söderling J., et al. Association Between Collagenous and Lymphocytic Colitis and Risk of Severe Coronavirus Disease 2019 // Gastroenterology. 2021. Vol. 160, N. 7. P. 2585–2587.e3. doi: 10.1053/j.gastro.2021.02.029

[73] Millien V, Rosen D, Hou J, Shah R. Proinflammatory Sulfur-Reducing Bacteria Are More Abundant in Colonic Biopsies of Patients with Microscopic Colitis Compared to Healthy Controls. Dig Dis Sci. 2019;64:432–438. doi: 10.1007/s10620-018-5313-z

[74] Millien V., Rosen D., Hou J., Shah R. Proinflammatory Sulfur-Reducing Bacteria Are More Abundant in Colonic Biopsies of Patients with Microscopic Colitis Compared to Healthy Controls // Dig Dis Sci. 2019. Vol. 64. P. 432–438. doi: 10.1007/s10620-018-5313-z

[75] Morgan DM, Cao Y, Miller K, et al. Microscopic colitis is characterized by intestinal dysbiosis. Clin Gastroenterol Hepatol. 2020;18:984–986. doi: 10.1016/j.cgh.2019.06.035

[76] Morgan D.M., Cao Y., Miller K., et al. Microscopic colitis is characterized by intestinal dysbiosis // Clin Gastroenterol Hepatol. 2020. Vol. 18. P. 984–986. doi: 10.1016/j.cgh.2019.06.035

[77] Hertz S, Durack J, Kirk KF, et al. Microscopic colitis patients possess a perturbed and inflammatory gut microbiota. Dig Dis Sci. 2022;67:2433–2443. doi: 10.1007/s10620-021-07045-8

[78] Hertz S., Durack J., Kirk K.F., et al. Microscopic colitis patients possess a perturbed and inflammatory gut microbiota // Digestive Diseases and Sciences. 2022. Vol. 67. P. 2433–2443. doi: 10.1007/s10620-021-07045-8

[79] Norén E, Mellander MR, Almer S, Söderman J. Genetic Variation and Gene Expression Levels of Tight Junction Genes Indicates Relationships Between PTEN as well as MAGI1 and Microscopic Colitis. Dig Dis Sci. 2018;63(1):105–12. doi: 10.1007/s10620-017-4857-7

[80] Norén E., Mellander M.R., Almer S., Söderman J. Genetic Variation and Gene Expression Levels of Tight Junction Genes Indicates Relationships Between PTEN as well as MAGI1 and Microscopic Colitis // Dig Dis Sci. 2018. Vol. 63, N. 1. P. 105–12. doi: 10.1007/s10620-017-4857-7

[81] Fernández-Bañares F, de Sousa MR, Salas A, et al. Epidemiological risk factors in microscopic colitis: a prospective case-control study. Inflamm Bowel Dis. 2013;19:411–7. doi: 10.1002/ibd.23009

[82] Fernández-Bañares F., de Sousa M.R., Salas A., et al. Epidemiological risk factors in microscopic colitis: a prospective case-control study // Inflamm Bowel Dis. 2013. Vol. 19. P. 411–7. doi: 10.1002/ibd.23009

[83] Verhaegh BPM, Münch A, Guagnozzi D, et al. Course of Disease in Patients with Microscopic Colitis: A European Prospective Incident Cohort Study. J Crohns Colitis. 2021;15(7):1174–1183. doi: 10.1093/ecco-jcc/jjab007

[84] Verhaegh B.P.M., Münch A., Guagnozzi D., et al. Course of Disease in Patients with Microscopic Colitis: A European Prospective Incident Cohort Study // J Crohns Colitis. 2021. Vol. 15, N. 7. P. 1174–1183. doi: 10.1093/ecco-jcc/jjab007

[85] Münch A, Langner C. Microscopic colitis: clinical and pathologic perspectives. Clin Gastroenterol Hepatol. 2015;13(2):228–36. doi: 10.1016/j.cgh.2013.12.026

[86] Münch A., Langner C. Microscopic colitis: clinical and pathologic perspectives // Clin Gastroenterol Hepatol. 2015. Vol. 13, N. 2. P. 228–36. doi: 10.1016/j.cgh.2013.12.026

[87] Raju SA, Rawcliffe ME, Bowker-Howell FJ, et al. Coeliac Disease and Microscopic Colitis: The Largest Study Assessing Prognosis and Risk of Hospital Admission. Nutrients. 2024;16(13):2081. doi: 10.3390/nu16132081

[88] Raju S.A., Rawcliffe M.E., Bowker-Howell F.J., et al. Coeliac Disease and Microscopic Colitis: The Largest Study Assessing Prognosis and Risk of Hospital Admission // Nutrients. 2024. Vol. 16, N. 13. P. 2081. doi: 10.3390/nu16132081

[89] Munck LK, Wildt S, Borup C. Bile Acid Diarrhea in Microscopic Colitis. Clin Gastroenterol Hepatol. 2023;23:S1542–3565. doi: 10.1016/j.cgh.2023.11.043

[90] Munck L.K., Wildt S., Borup C. Bile Acid Diarrhea in Microscopic Colitis // Clin Gastroenterol Hepatol. 2023. Vol. 23. P. S1542–3565. doi: 10.1016/j.cgh.2023.11.043

[91] Redd WD, Anderson C, Peery AF, et al. Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year. GastroHep Adv. 2024;3(3):336–343. doi: 10.1016/j.gastha.2023.11.019

[92] Redd W.D., Anderson C., Peery A.F., et al. Follow-Up of Microscopic Colitis Patients and Diarrhea Controls at 1 Year // GastroHep Adv. 2024. Vol. 3, N. 3. P. 336–343. doi: 10.1016/j.gastha.2023.11.019

[93] Mearin F, Lacy BE, Chang L, et al. Bowel Disorders. Gastroenterology. 2016;18:S0016–5085(16)00222–5. doi: 10.1053/j.gastro.2016.02.031

[94] Mearin F., Lacy B.E., Chang L., et al. Bowel Disorders // Gastroenterology. 2016. Vol. 18. P. S0016–5085(16)00222–5. doi: 10.1053/j.gastro.2016.02.031

[95] Rusu F, Caragut RL, Mocanu LC, et al. Microscopic Colitis: ADiagnostic Challenge in Patients with Irritable Bowel Syndrome. J Gastrointestin Liver Dis. 2023;32(4):469–472. doi: 10.15403/jgld-5025

[96] Rusu F., Caragut R.L., Mocanu L.C., Leucuta D.C., Dumitrascu D.L. Microscopic Colitis: A Diagnostic Challenge in Patients with Irritable Bowel Syndrome // J Gastrointestin Liver Dis. 2023. Vol. 32, N. 4. P. 469–472. doi: 10.15403/jgld-5025

[97] Songtanin B, Kahathuduwa C, Nugent K. Fecal calprotectin level in microscopic colitis: a systematic review and meta-analysis. Proc. 2023;36(5):641–646. doi: 10.1080/08998280.2023.2223950

[98] Songtanin B., Kahathuduwa C., Nugent K. Fecal calprotectin level in microscopic colitis: a systematic review and meta-analysis // Proc. 2023. Vol. 36, N. 5. P. 641–646. doi: 10.1080/08998280.2023.2223950

[99] Barta Z, Mekkel G, Csípo I, et al. Microscopic colitis: a retrospective study of clinical presentation in 53 patients. World J Gastroenterol. 2005;11(9):1351–5. doi: 10.3748/wjg.v11.i9.1351

[100] Barta Z., Mekkel G., Csípo I., et al. Microscopic colitis: a retrospective study of clinical presentation in 53 patients // World J Gastroenterol. 2005. Vol. 11, N. 9. P. 1351–5. doi: 10.3748/wjg.v11.i9.1351

[101] Kang X, Liu S, Roelstraete B, et al. Type 1 diabetes and microscopic colitis: A nationwide matched case-control study in Sweden. Aliment Pharmacol Ther. 2023;57(12):1423–1431. doi: 10.1111/apt.17473

[102] Kang X., Liu S., Roelstraete B., et al. Type 1 diabetes and microscopic colitis: A nationwide matched case-control study in Sweden // Aliment Pharmacol Ther. 2023. Vol. 57, N. 12. P. 1423–1431. doi: 10.1111/apt.17473

[103] Bergman D, Ebrahimi F, Sun J, et al. Inflammatory eye disease is a risk factor for future microscopic colitis: A nationwide population-based matched case control study. United European Gastroenterol J. 2024;12(8):1081–1090. doi: 10.1002/ueg2.12623

[104] Bergman D., Ebrahimi F., Sun J., et al. Inflammatory eye disease is a risk factor for future microscopic colitis: A nationwide population-based matched case control study // United European Gastroenterol J. 2024. Vol. 12, N. 8. P. 1081–1090. doi: 10.1002/ueg2.12623

[105] Macaigne G, Lahmek P, Locher C, et al. Microscopic colitis or functional bowel disease with diarrhea: a French prospective multicenter study. Am J Gastroenterol. 2014;109(9):1461–70. doi: 10.1038/ajg.2014.182

[106] Macaigne G., Lahmek P., Locher C., et al. Microscopic colitis or functional bowel disease with diarrhea: a French prospective multicenter study // Am J Gastroenterol. 2014. Vol. 109, N. 9. P. 1461–70. doi: 10.1038/ajg.2014.182

[107] Madisch A, Miehlke S, Bartosch F, et al. Microscopic colitis: clinical presentation, treatment and outcome of 494 patients. Z Gastroenterol. 2014;52(9):1062–5. doi: 10.1055/s-0034-1366281

[108] Madisch A., Miehlke S., Bartosch F., et al. Microscopic colitis: clinical presentation, treatment and outcome of 494 patients // Z Gastroenterol. 2014. Vol. 52, N. 9. P. 1062–5. doi: 10.1055/s-0034-1366281

[109] Forss A, Bergman D, Roelstraete B, et al. Patients with Microscopic Colitis Are at Higher Risk of Major Adverse Cardiovascular Events: A Matched Cohort Study. Clin Gastroenterol Hepatol. 2023;21(13):3356-3364.e9. doi: 10.1016/j.cgh.2023.05.014

[110] Forss A., Bergman D., Roelstraete B., et al. Patients with Microscopic Colitis Are at Higher Risk of Major Adverse Cardiovascular Events: A Matched Cohort Study // Clin Gastroenterol Hepatol. 2023. Vol. 21, N. 13. P. 3356–3364.e9. doi: 10.1016/j.cgh.2023.05.014

[111] Hong P, Krawczyk K, Awan RU, et al. Prevalence of Atherosclerotic Disease in Microscopic Colitis Patients. Gastro Hep Advances. 2023;2(7):971–978. doi: 10.1016/j.gastha.2023.07.002

[112] Hong P., Krawczyk K., Awan R.U., et al. Prevalence of Atherosclerotic Disease in Microscopic Colitis Patients // Gastro Hep Advances. 2023. Vol. 2, N. 7. P. 971–978. doi: 10.1016/j.gastha.2023.07.002

[113] Miyatani Y, Komaki Y, Komaki F, et al. Factors associated with long-term clinical outcome in microscopic colitis. Ann Med. 2024;56(1):2365989. doi: 10.1080/07853890.2024.2365989

[114] Miyatani Y., Komaki Y., Komaki F., et al. Factors associated with long-term clinical outcome in microscopic colitis // Ann Med. 2024. Vol. 56, N. 1. P. 2365989. doi: 10.1080/07853890.2024.2365989

[115] Malik A, Goyal H, Adler DG, et al. Budesonide Versus Mesalamine in Microscopic Colitis: A Comparative Meta-analysis of Randomized Controlled Trials. J Clin Gastroenterol. 2024. doi: 10.1097/MCG.0000000000002025

[116] Malik A., Goyal H., Adler D.G., et al. Budesonide Versus Mesalamine in Microscopic Colitis: A Comparative Meta-analysis of Randomized Controlled Trials // J Clin Gastroenterol. 2024. doi: 10.1097/MCG.0000000000002025

[117] Sebastian S, Wilhelm A, Jessica L, et al. Budesonide treatment for microscopic colitis: systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2019;31:919–927. doi: 10.1097/MEG.0000000000001456

[118] Sebastian S., Wilhelm A., Jessica L., et al. Budesonide treatment for microscopic colitis: systematic review and meta-analysis // Eur J Gastroenterol Hepatol. 2019. Vol. 31. P. 919–927. doi: 10.1097/MEG.0000000000001456

[119] El Hage Chehade N, Ghoneim S, Shah S, et al. Efficacy and Safety of Vedolizumab and Tumor Necrosis Factor Inhibitors in the Treatment of Steroid-refractory Microscopic Colitis: A Systematic Review and Meta-analysis. J Clin Gastroenterol. 2024;58(8):789–799. doi: 10.1097/MCG.0000000000001914

[120] El Hage Chehade N., Ghoneim S., Shah S., et al. Efficacy and Safety of Vedolizumab and Tumor Necrosis Factor Inhibitors in the Treatment of Steroid-refractory Microscopic Colitis: A Systematic Review and Meta-analysis // J Clin Gastroenterol. 2024. Vol. 58, N. 8. P. 789–799. doi: 10.1097/MCG.0000000000001914

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