Lymphocytic Colitis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Lymphocytic Colitis?
A gastroenterologist, a doctor who treats digestive diseases, usually guides care for lymphocytic colitis. This is a long-term swelling of the colon. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is lymphocytic colitis?
Lymphocytic colitis is one of two types of microscopic colitis. This is a long-term (chronic) disease. The immune system reacts in an abnormal way. This causes inflammation (swelling) on the inner lining of the colon, or large intestine. Doctors can only see this inflammation by looking at colon tissue under a microscope.
In lymphocytic colitis, the colon lining contains more white blood cells than normal. The other type is collagenous colitis. Doctors call both types microscopic colitis, and they have the same symptoms and treatments.
It is a type of inflammatory bowel disease (IBD). Unlike the other types of IBD, it does not increase your risk of developing colon cancer.
Symptoms
Symptoms may include:
- Chronic, watery, nonbloody diarrhea, which is the most common symptom.
- Diarrhea that occurs at night.
- Pain in the abdomen (belly).
- An urgent need to have a bowel movement.
- Fecal incontinence, which means leaking stool.
- Weight loss.
- Fatigue, or feeling tired.
Symptoms may start suddenly or begin gradually and become worse over time. Many people go to the bathroom four to nine times a day. Some go more than 10 times. You may have remission, a time when you have fewer symptoms or none. A relapse is a time when symptoms return or worsen.
Severe diarrhea may lead to weight loss and dehydration (too little fluid in the body).
Causes and who gets it
Doctors are not sure what causes microscopic colitis. Abnormal immune reactions may play a role. So may genes, certain medicines, and smoking.
People with some immune disorders are more likely to develop it. These include celiac disease, rheumatoid arthritis, and type 1 diabetes. Certain medicines may raise the risk too. They include NSAIDs (a type of pain reliever), proton pump inhibitors (PPIs), SSRIs (a type of antidepressant), and statins (cholesterol medicines). Follow your doctor's instructions about any medicine you take.
Anyone can develop microscopic colitis. It is more common in older adults. The average age at diagnosis is 60 to 65 years. It can occur at any age, including in children. Research suggests it is three to nine times more common in women than in men. People who smoke are also more likely to get it. About 700,000 people in the United States have it.
How doctors diagnose it
Doctors can only see the inflammation by looking at colon tissue under a microscope. In lymphocytic colitis, that tissue shows more white blood cells than normal. Ask your doctor which tests are right for you.
Treatment
To treat microscopic colitis, your doctor may recommend:
- Quitting smoking, if you smoke.
- Changing any medicines you take that could be causing it or making your symptoms worse.
- Taking medicines to treat it.
- Changing what you eat and drink to help improve symptoms.
Medicines most often treat microscopic colitis effectively. Doctors may use steroids (corticosteroids), most often budesonide. Other choices include aminosalicylates, antidiarrheal medicines, bile acid binders, immunosuppressants, and biologics. Doctors rarely suggest surgery. It may be an option if severe symptoms do not improve with medicines.
When to see a doctor
Talk with a doctor if you have chronic watery diarrhea, weight loss, or belly pain. Severe diarrhea can lead to dehydration, so tell your doctor.
In rare cases, microscopic colitis may cause serious complications, such as ulcers or perforation of the colon. Call 911 or go to the emergency room if you have severe belly pain or pressure, or if you faint.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your medicines and refer you to a gastroenterologist. They can also track your symptoms over time.
Common questions
Is lymphocytic colitis the same as collagenous colitis?
No, they are two types of microscopic colitis. They cause different changes in colon tissue. But they have the same symptoms and treatments.
Does lymphocytic colitis raise the risk of colon cancer?
No. Unlike the other types of inflammatory bowel disease, microscopic colitis does not raise your risk of colon cancer.
Can lymphocytic colitis symptoms go away?
Yes, symptoms can go away for a time. They can also come back. A time with fewer or no symptoms is remission. A return of symptoms is a relapse. Medicines most often treat it well.
Who is most likely to get lymphocytic colitis?
Older adults and women are more likely to get it. It is three to nine times more common in women than in men, research suggests. Smokers are also more likely to get it.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Definition & Facts of Microscopic Colitis
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Symptoms & Causes of Microscopic Colitis
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Treatment for Microscopic Colitis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
