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World J Gastroenterol. Aug 7, 2015; 21(29): 8804-8810
Published online Aug 7, 2015. doi: 10.3748/wjg.v21.i29.8804
Microscopic colitis: A review of etiology, treatment and refractory disease
Tina Park, David Cave, Christopher Marshall
Tina Park, David Cave, Christopher Marshall, Department of Medicine, Division of Gastroenterology, University of Massachusetts, Worcester, MA 01655, United States
Author contributions: Park T performed literature search, wrote the paper, and revised the paper; Cave D and Marshall C provided guidance and contributed to the revision of the article.
Conflict-of-interest statement: Tina Park is a gastroenterology fellow at University of Massachusetts (Worcester, MA). David Cave is an attending gastroenterologist and professor of medicine at University of Massachusetts (Worcester, MA). Christopher Marshall is an attending gastroenterologist and assistant professor of medicine at University of Massachusetts (Worcester, MA). All authors report no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Christopher Marshall, MD, Assistant Professor, Department of Medicine, Division of Gastroenterology, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01655, United States. christopher.marshall@umassmemorial.org
Telephone: +1-508-8563068 Fax: +1-508-856-3981
Received: April 14, 2015
Peer-review started: April 16, 2015
First decision: May 18, 2015
Revised: June 9, 2015
Accepted: June 16, 2015
Article in press: June 16, 2015
Published online: August 7, 2015
Processing time: 116 Days and 0.7 Hours
Core Tip

Core tip: The etiology of microscopic colitis (MC) is unknown. There is a strong association with autoimmune disorders, smoking, and medications, such as non-steroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors. There are no societal guidelines on how to manage patients with MC. Data is strongest for the use of budesonide. Budesonide can rapidly induce clinical remission but relapse occurs frequently after discontinuation of budesonide. Anti-diarrheals may be used alone in mild MC or in conjunction with other therapies in moderate to severe MC. There is limited data on management of steroid-dependent or refractory MC but anti-TNF and diverting ileostomy may be options.