Prevalence of Microscopic Colitis among Egyptian Patients with Diarrhea Predominant Irritable Bowel Syndrome

Background: Microscopic colitis (MC) is more prevalent in women than in men. In middle-aged patients, it is the most prevalent chronic inflammatory disease of the colon. Although there is no defined and organic pathology, irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder. Abdominal distress and altered defecation habits are its distinguishing characteristics. Aimed to an examination of the prevalence of MC among Egyptian patients with IBS-D. Methods: This observational cross-sectional study included 100 patients with IBS-D who were 18 years of age or older and were seen in the outpatient clinic at Benha University Hospitals' Department of Internal Medicine. Results: The history of use of PPI was significantly lower in patients with MC compared to patients without MC (P<0.05). Among the different clinical manifestations, abdominal distention, weight loss and fever, the duration of diarrhea and the bowel motion frequency, CRP level, ESR and fecal calprotectin level were significantly higher in patients with MC compared to patients without MC (P<0.05). Conclusion: The diagnosis of MC is not uncommon. It is easy to confound colonoscopy specimens derived from the typically appearing mucosa with IBS-D, which is why the primary method of differentiation is the histopathological examination. It is imperative to perform a Colonoscopic biopsy evaluation in patients with IBS-D, as it increases the likelihood of MC, nocturnal diarrhea, and weight loss. However, these markers are non-specific and do not serve as diagnostic indicators for MC. Inflammatory markers (ESR, FC, and CRP) may exhibit modest increases in patients with IBS-D.