Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Pharmacol Ther. Sep 5, 2026; 17(3): 119904
Published online Sep 5, 2026. doi: 10.4292/wjgpt.119904
Published online Sep 5, 2026. doi: 10.4292/wjgpt.119904
Letter to the Editor: Less can be more, rethinking colonic biopsy strategies for microscopic colitis in the era of green endoscopy
Himanshu Agrawal, Department of Surgery, University College of Medical Sciences (University of Delhi), GTB Hospital, Delhi 110095, India
Nikhil Gupta, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Delhi 110001, India
Co-first authors: Himanshu Agrawal and Nikhil Gupta.
Author contributions: Agrawal H conceptualized the article framework, performed the critical appraisal of the referenced study, drafted the initial manuscript, and revised the manuscript for important intellectual content; Gupta N contributed to the development of the central argument, provided critical revisions for scientific accuracy and policy perspective, and approved the final version of the manuscript; both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Nikhil Gupta, Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, BKS Marg, Delhi 110001, India.
Received: February 10, 2026
Revised: March 2, 2026
Accepted: April 10, 2026
Published online: September 5, 2026
Processing time: 199 Days and 19.1 Hours
Revised: March 2, 2026
Accepted: April 10, 2026
Published online: September 5, 2026
Processing time: 199 Days and 19.1 Hours
Core Tip
Core Tip: Routine bilateral colonic biopsies for suspected microscopic colitis (MC) are rooted more in tradition than contemporary evidence. Emerging data suggest that right-sided colonic biopsies alone may be sufficient for diagnosis, without compromising accuracy. Reconsidering biopsy strategies offers an opportunity to maintain diagnostic rigor while reducing procedural burden, costs, and environmental impact-aligning MC diagnosis with principles of precision and sustainable gastroenterology.