D Guagnozzi1, Á Arias2, A J Lucendo3. 1. Department of Gastroenterology, Hospital General Universitario Vall d'Hebron, Barcelona, Spain. 2. Research Support Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Spain. 3. Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.
Abstract
BACKGROUND: Microscopic colitis shares certain common clinical manifestations with functional bowel disorders, especially diarrhoea-dominant irritable bowel syndrome (IBS) and functional diarrhoea. However, the exact relationship between microscopic colitis and functional bowel disorders has not been systematically assessed. AIM: To conduct a systematic review and meta-analysis on the diagnostic overlap between functional bowel disorders and microscopic colitis. METHODS: We searched MEDLINE, EMBASE and SCOPUS databases, as well as the abstract books of the major gastroenterology meetings, to investigate the prevalence of microscopic colitis among patients with functional bowel disorders (considering all subtypes of both disorders) and vice versa. Data were pooled with a random-effects model. RESULTS: Of 227 references identified, data were collected from 26 studies and a total of 5,099 adult patients. The pooled prevalence any type of functional bowel disorders in patients who present diagnostic criteria of microscopic colitis was 39.1% (95% CI: 22.8-56.6%; I2 : 97%) and was higher for lymphocytic colitis than for collagenous colitis (40.7% vs. 28.4%, respectively; P = 0.58). The prevalence of microscopic colitis in functional bowel disorders patients was 7% (95% CI: 3.6-11.4%), reaching 9.8% (95% CI: 4.4-17.1%; I2 : 95%) in patients exhibiting diarrhoea-dominant IBS, nonsignificantly higher than microscopic colitis rates among patients with constipation-dominant IBS (1.3%) or mixed-dominant IBS (1.9%). CONCLUSIONS: There is a significant overlap of symptoms between microscopic colitis and functional bowel disorders, especially in diarrhoeal subtypes. The high proportion of microscopic colitis among diarrhoea-dominant functional syndromes should serve as a call for more active diagnosis in selected patients.
BACKGROUND: Microscopic colitis shares certain common clinical manifestations with functional bowel disorders, especially diarrhoea-dominant irritable bowel syndrome (IBS) and functional diarrhoea. However, the exact relationship between microscopic colitis and functional bowel disorders has not been systematically assessed. AIM: To conduct a systematic review and meta-analysis on the diagnostic overlap between functional bowel disorders and microscopic colitis. METHODS: We searched MEDLINE, EMBASE and SCOPUS databases, as well as the abstract books of the major gastroenterology meetings, to investigate the prevalence of microscopic colitis among patients with functional bowel disorders (considering all subtypes of both disorders) and vice versa. Data were pooled with a random-effects model. RESULTS: Of 227 references identified, data were collected from 26 studies and a total of 5,099 adult patients. The pooled prevalence any type of functional bowel disorders in patients who present diagnostic criteria of microscopic colitis was 39.1% (95% CI: 22.8-56.6%; I2 : 97%) and was higher for lymphocytic colitis than for collagenous colitis (40.7% vs. 28.4%, respectively; P = 0.58). The prevalence of microscopic colitis in functional bowel disorderspatients was 7% (95% CI: 3.6-11.4%), reaching 9.8% (95% CI: 4.4-17.1%; I2 : 95%) in patients exhibiting diarrhoea-dominant IBS, nonsignificantly higher than microscopic colitis rates among patients with constipation-dominant IBS (1.3%) or mixed-dominant IBS (1.9%). CONCLUSIONS: There is a significant overlap of symptoms between microscopic colitis and functional bowel disorders, especially in diarrhoeal subtypes. The high proportion of microscopic colitis among diarrhoea-dominant functional syndromes should serve as a call for more active diagnosis in selected patients.
Authors: Edoardo Savarino; Fabiana Zingone; Brigida Barberio; Giovanni Marasco; Filiz Akyuz; Hale Akpinar; Oana Barboi; Giorgia Bodini; Serhat Bor; Giuseppe Chiarioni; Gheorghe Cristian; Maura Corsetti; Antonio Di Sabatino; Anca Mirela Dimitriu; Vasile Drug; Dan L Dumitrascu; Alexander C Ford; Goran Hauser; Radislav Nakov; Nisha Patel; Daniel Pohl; Cătălin Sfarti; Jordi Serra; Magnus Simrén; Alina Suciu; Jan Tack; Murat Toruner; Julian Walters; Cesare Cremon; Giovanni Barbara Journal: United European Gastroenterol J Date: 2022-06-13 Impact factor: 6.866
Authors: Kyle Staller; Ola Olén; Jonas Söderling; Bjorn Roelstraete; Hans Törnblom; Hamed Khalili; Mingyang Song; Jonas F Ludvigsson Journal: Eur J Intern Med Date: 2021-08-20 Impact factor: 4.487
Authors: Anne-Marie Kanstrup Fiehn; Stephan Miehlke; Daniela Aust; Michael Vieth; Ole Bonderup; Fernando Fernández-Bañares; Emese Mihaly; Juozas Kupcinskas; Ahmed Madisch; Lars Kristian Munck; Tanju Nacak; Ralf Mohrbacher; Ralph Mueller; Roland Greinwald; Andreas Münch Journal: Int J Colorectal Dis Date: 2020-09-12 Impact factor: 2.571
Authors: Stephan Miehlke; Danila Guagnozzi; Yamile Zabana; Gian E Tontini; Anne-Marie Kanstrup Fiehn; Signe Wildt; Johan Bohr; Ole Bonderup; Gerd Bouma; Mauro D'Amato; Peter J Heiberg Engel; Fernando Fernandez-Banares; Gilles Macaigne; Henrik Hjortswang; Elisabeth Hultgren-Hörnquist; Anastasios Koulaouzidis; Jouzas Kupcinskas; Stefania Landolfi; Giovanni Latella; Alfredo Lucendo; Ivan Lyutakov; Ahmed Madisch; Fernando Magro; Wojciech Marlicz; Emese Mihaly; Lars K Munck; Ann-Elisabeth Ostvik; Árpád V Patai; Plamen Penchev; Karolina Skonieczna-Żydecka; Bas Verhaegh; Andreas Münch Journal: United European Gastroenterol J Date: 2021-02-22 Impact factor: 4.623