One kind of microscopic colitis that produces chronic, watery diarrhea is called lymphhocytic colitis. This kind of inflammatory bowel disease targets the large intestine, or colon. When the immune system targets the colon lining cells, it might result in lymphhocytic colitis, which is characterized by inflammation and damage. Although anybody can have lymphocytic colitis, women and older persons are more likely to get it. Although the precise etiology of lymphocytic colitis is uncertain, it may be attributed to genetics, autoimmune diseases, drugs, or infections. A colonoscopy and a sample of the colon tissue are two methods used to identify lymphocytic colitis. Medication, dietary modifications, and surgery are available as forms of treatment.
The cause of lymphocytic colitis is not fully understood, but it may involve a combination of factors that trigger the immune system to attack the colon lining. Some of the possible factors are:
Infections, such as bacteria, viruses, fungi, or parasites, that can cause inflammation and irritation in the colon
Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, antidepressants, or proton pump inhibitors, that can affect the balance and function of the colon lining
Autoimmune disorders, such as celiac disease, rheumatoid arthritis, or thyroid disease, that can cause the immune system to produce antibodies that target the colon cells
Genetic factors, such as certain genes or family history, that can make the colon more susceptible to inflammation and damage
The main symptom of lymphocytic colitis is chronic, watery diarrhea, which can last for weeks or months. The diarrhea may occur several times a day and may be accompanied by abdominal pain, cramps, or bloating. Other symptoms may include:
Weight loss, due to loss of fluids and nutrients
Dehydration, due to excessive fluid loss
Malabsorption, due to impaired absorption of vitamins and minerals
Fatigue, due to lack of energy and hydration
Nausea, due to irritation of the stomach and intestines
A physician will inquire about the patient's symptoms, medical history, and risk factors in order to make the diagnosis of lymphocytic colitis. In addition, the physician will do a physical examination to look for any indications of inflammation, anemia, or dehydration. In order to confirm the diagnosis and rule out other illnesses, the doctor could additionally prescribe certain tests, such as:
Blood tests, which can check for signs of infection, inflammation, anemia, or kidney function
Stool tests, which can check for the presence of blood, mucus, or parasites in the stool
Colonoscopy, which is a procedure that involves inserting a thin, flexible tube with a camera and a light into the colon to examine its lining and take samples of tissue
Biopsy, which is a procedure that involves analyzing the tissue samples under a microscope to look for signs of inflammation and damage in the colon cells
The treatment of lymphocytic colitis depends on the severity, frequency, and impact of the symptoms. The main goals of the treatment are to reduce the inflammation, control the diarrhea, and prevent complications. The treatment options may include:
Medications, such as anti-diarrheal drugs, anti-inflammatory drugs, corticosteroids, immunosuppressants, or biologics, that can help reduce the inflammation, regulate the immune system, and relieve the symptoms
Dietary changes, such as avoiding foods that can worsen the diarrhea, such as dairy products, spicy foods, fatty foods, or caffeine, and increasing the intake of fluids, fiber, and probiotics, that can help restore the balance and function of the colon lining
Surgery, which is a procedure that involves removing part or all of the colon, that may be considered in severe or refractory cases that do not respond to medications or dietary changes
There is no definitive way to prevent lymphocytic colitis, as the exact cause is unknown. However, some preventive measures that may help reduce the risk or severity of the condition are:
Avoiding or limiting the use of medications that can irritate the colon, such as NSAIDs, antibiotics, antidepressants, or proton pump inhibitors, and consulting the doctor before starting or stopping any medication
Avoiding or treating infections that can cause inflammation in the colon, such as bacteria, viruses, fungi, or parasites, and practicing good hygiene and sanitation
Managing or treating autoimmune disorders that can affect the colon, such as celiac disease, rheumatoid arthritis, or thyroid disease, and following the doctor’s advice and recommendations
Following a healthy and balanced diet, that can provide adequate hydration, nutrition, and fiber, and avoiding foods that can trigger or worsen the diarrhea, such as dairy products, spicy foods, fatty foods, or caffeine
Exercising regularly and moderately, that can improve the blood circulation, the immune system, and the bowel movements, and reducing stress and practicing relaxation techniques, that can lower the inflammation and the irritation in the colon
