Gilles Macaigne1, Pierre Lahmek2, Christophe Locher3, Bruno Lesgourgues4, Laurent Costes5, Max Pierre Nicolas6, Anne Courillon-Mallet7, Jean-Michel Ghilain8, Guy Bellaïche9, Stéphanie de Montigny-Lehnardt10, Georges Barjonet11, René-Louis Vitte12, Roger Faroux13, Benedicte Lambare14, Antoine Fleury15, Alexandre Pariente16, Stéphane Nahon17. 1. Service de Gastro-Entérologie, Centre Hospitalier de Marne la Vallée, Jossigny, France. 2. Service de Gastro-Entérologie, Centre Hospitalier de Limeil-Brévannes, Limeil-Brévannes, France. 3. Service de Gastro-Entérologie, Centre Hospitalier de Meaux, Meaux, France. 4. Service de Gastro-Entérologie, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France. 5. Service de Gastro-Entérologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France. 6. Service de Gastro-Entérologie, Centre Hospitalier de Montauban, Montauban, France. 7. Service de Gastro-Entérologie, Centre Hospitalier Intercommunal de Villeneuve Saint-Georges, Villeneuve Saint-Georges, France. 8. Service de Gastro-Entérologie, Centre Hospitalier de Jolimont, Jolimont, Belgique. 9. Service de Gastro-Entérologie, Centre Hospitalier Intercommunal d'Aulnay sous Bois, Aulnay sous bois, France. 10. Service de Gastro-Entérologie, Centre Hospitalier d'Aubagne, Aubagne, France. 11. Service de Gastro-Entérologie, Centre Hospitalier de Coulommiers, Coulommiers, France. 12. Service de Gastro-Entérologie, Centre Hospitalier Intercommunal de Poissy, Poissy, France. 13. Service de Gastro-Entérologie, Centre Hospitalier départemental de La Roche sur Yon, La Roche sur Yon, France. 14. Service de Gastro-Entérologie, Centre Hospitalier Sud Francilien, Evry, France. 15. Service de Gastro-Entérologie, Centre Hospitalier de Neuilly sur Seine, Neuilly sur seine, France. 16. 1] Service de Gastro-Entérologie, Centre Hospitalier de Pau, Pau, France [2] These authors contributed equally to this work. 17. 1] Service de Gastro-Entérologie, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France [2] These authors contributed equally to this work [3] Full investigators are listed before study highlights.
Abstract
OBJECTIVES: To describe the characteristics of a cohort of patients with microscopic colitis (MC; lymphocytic (LC) or collagenous (CC) colitis) and to compare them with patients with functional bowel disorder with diarrhea (FBD-D). METHODS: Between September 2010 and June 2012, patients fulfilling the following inclusion criteria were prospectively included in 26 centers in France: (i) having at least three bowel movements daily with change in stool consistency; (ii) duration of abnormal bowel habit >4 weeks; and (iii) normal or near-normal colonoscopy. Each patient underwent a colonoscopy and colonic biopsies. We compared the demographic, clinical, biological, and etiological characteristic of patients with MC (CC and LC) with those of control patients with FBD-D. RESULTS: A total of 433 patients were included: 129 with MC (87 LC and 42 CC), 23 with another organic disease, and 278 with FDB-D, including patients with diarrhea and abdominal pain who met the criteria of Rome III (irritable bowel syndrome with diarrhea) and patients with functional diarrhea without abdominal pain. Logistic regression analysis identified the following independent predictors of MC: age >50 years (odds ratio (OR)=3.1, 95% confidence interval (CI)=1.6-5.9), presence of nocturnal stools (OR=2, 95% CI=1.1-3.9), weight loss (OR=2.5, 95% CI=1.3-4.7), duration of diarrhea <12 months (OR=2.0, 95% CI=1.1-3.5), recent introduction of new drugs (OR=3.7, 95% CI=2.1-6.6; P<0.0001), and the presence of a known autoimmune disorder (OR=5.5, 95% CI=2.5-12). CONCLUSIONS: Age >50 years, the presence of nocturnal stools, weight loss, the introduction of a new drug, and the presence of a known autoimmune disease increase the probability of MC and thus the indication for colonoscopy with biopsies.
OBJECTIVES: To describe the characteristics of a cohort of patients with microscopic colitis (MC; lymphocytic (LC) or collagenous (CC) colitis) and to compare them with patients with functional bowel disorder with diarrhea (FBD-D). METHODS: Between September 2010 and June 2012, patients fulfilling the following inclusion criteria were prospectively included in 26 centers in France: (i) having at least three bowel movements daily with change in stool consistency; (ii) duration of abnormal bowel habit >4 weeks; and (iii) normal or near-normal colonoscopy. Each patient underwent a colonoscopy and colonic biopsies. We compared the demographic, clinical, biological, and etiological characteristic of patients with MC (CC and LC) with those of control patients with FBD-D. RESULTS: A total of 433 patients were included: 129 with MC (87 LC and 42 CC), 23 with another organic disease, and 278 with FDB-D, including patients with diarrhea and abdominal pain who met the criteria of Rome III (irritable bowel syndrome with diarrhea) and patients with functional diarrhea without abdominal pain. Logistic regression analysis identified the following independent predictors of MC: age >50 years (odds ratio (OR)=3.1, 95% confidence interval (CI)=1.6-5.9), presence of nocturnal stools (OR=2, 95% CI=1.1-3.9), weight loss (OR=2.5, 95% CI=1.3-4.7), duration of diarrhea <12 months (OR=2.0, 95% CI=1.1-3.5), recent introduction of new drugs (OR=3.7, 95% CI=2.1-6.6; P<0.0001), and the presence of a known autoimmune disorder (OR=5.5, 95% CI=2.5-12). CONCLUSIONS: Age >50 years, the presence of nocturnal stools, weight loss, the introduction of a new drug, and the presence of a known autoimmune disease increase the probability of MC and thus the indication for colonoscopy with biopsies.
Authors: Gwen M C Masclee; Preciosa M Coloma; Ernst J Kuipers; Miriam C J M Sturkenboom Journal: Am J Gastroenterol Date: 2015-04-28 Impact factor: 10.864
Authors: Ruchit Sood; Michael Camilleri; David J Gracie; Matthew J Gold; Natalie To; Graham R Law; Alexander C Ford Journal: Am J Gastroenterol Date: 2016-08-02 Impact factor: 10.864