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I was perusing medical continuing education files on Medscape and came across a 2004 article about IBDs, including MC. It had very little about MC (LC and CC), but it did mention an alarmingly high rate of incidence. I found their conclusion fascinating...
Epidemiology of Microscopic Colitis Subtypes
Microscopic colitis (lymphocytic colitis or collagenous colitis) is a form of IBD that has not been studied epidemiologically in the United States until now. Using the Rochester Epidemiology Project in Minnesota (a medical records linkage system), 131 cases of microscopic colitis were identified over a 17-year period.[15] The mean age at diagnosis was 68 years, and 69% of subjects were women. Lymphocytic colitis, but not collagenous colitis, was found to be much more common among women (5.3:1). Age- and sex-adjusted incidence rates were about twice as high for lymphocytic colitis as for collagenous colitis. Additionally, incidence rates for microscopic colitis have been rising dramatically since 1985 (from 0.8/100,000 in 1985-1989, to 19.1/100,000 in 1998-2001). Such a rapid rise in incidence rates points toward an environmental (ie, infectious) etiology for this chronic disease.
From Medscape Gastroenterology
Select Topics in the Clinical Epidemiology of Inflammatory Bowel Disease
Bret A. Lashner, MD
Posted: 06/07/2004 http://www.medscape.org/viewarticle/480243
Is anyone looking for this infectious or otherwise environmental cause of our disease??? If anyone cared, we'd all be cured by now!
IMHO, we need to start an education and advocacy organization STAT or continue to be lost in the weeds, misunderstood or ignored.
Incidentally, I also read an article about diagnosis and management of IBS.
Alarm Signs and Symptoms
Alarm features are signs and symptoms that should immediately prompt the investigator to consider an alternative diagnosis, such as IBD or colon cancer. These 'red flags' include new onset of symptoms at 50 years or older, unintentional weight loss, nocturnal diarrhea, anemia, bloody stools, and family history of colon cancer, celiac disease or IBD...
The ACG IBS Task Force recommend that routine diagnostic testing should not be performed for patients with typical IBS symptoms without alarm features.[45] With the exception of tests for lactose intolerance and celiac disease, the prevalence of abnormalities of other diagnostic tests was not significantly different between patients with IBS with no alarm features and healthy controls...
Colonoscopy, in general, is not recommended in patients with IBS who do not have alarm signs. However, colonoscopy should be performed in patients with IBS who have alarm features to rule out organic disease, and in those over the age of 50 years as routine screening...
However, in the study by Chey et al.[67] random colonic biopsies were performed in patients with IBS-D and IBS-M, and demonstrated evidence of microscopic colitis in 2.3% of patients >45 years of age and nonspecific inflammation in 1.4% of the patients with IBS. Only the patients with IBS-D were found to have microscopic colitis. The ACG IBS Task Force recommend that when colonoscopy is performed in patients with IBS-D, random biopsy samples should be taken to rule out microscopic colitis.
So the current consensus is - no colonoscopy needed for IBS patients under age 45, BUT if you happen to do colonoscopy on a younger person with IBS-D, you should include biopsies to rule out MC.
IMHO, this may explain why MC continues to be a disease of older women -- because younger women are being refused testing!
Those are interesting articles. My husband ask me a question I couldn't answer. Maybe some one on this board can - Tex? Is there some one or some institution that is doing research on MC?
I have a 45-year-old friend whose mother died of colon cancer. She has requested a colonoscopy, and has been refused because her insurance will not pay for it. I have another friend who is 55, who told me that Kaiser Permanente (an HMO) changed their policy so that now the minimum age is 54 for a screening colonoscopy.
Marliss Bombardier
Dum spiro, spero -- While I breathe, I hope
Psoriasis - the dark ages
Hashimoto's Thyroiditis - Dec 2001
Collagenous Colitis - Sept 2010
Granuloma Annulare - June 2011
That seems unconscionable, and I'm surprised there isn't some way to force the issue. When I requested a bone density test, thinking I'd like an 'early' baseline, my PCP said my insurance wouldn't pay. The following year I decided I'd pay for it myself if I had to, but she beat me to the punch by ordering the test based on 'perimenopausal symptoms' (which I may or may not have been having at the time).
A friend's whose brother is a colon cancer survivor went for a screening as soon as he was diagnosed, when she was in her very early forties. In her screening, they found and removed a polyp. I can't imagine Kaiser Permanente would prefer to pay for cancer treatment than for prevention. But I do have a limited imagination when it comes to insurance-company-think. Colon cancer certain does occur before 50 or 54.
I hope your friend is able to make some headway toward having this test sooner rather than later,
Is there some one or some institution that is doing research on MC?
Right after I was diagnosed I received a request from the Mayo Clinic to participate in their study. I filled out the detailed questionnaire
but have not yet received a follow-up one which I thought was going to be in six months (which I'm approaching).
Is there some one or some institution that is doing research on MC?
I would say we are, right here.
If any academic body wanted to formalize MC research (perhaps some 'meta studies' of the all the relevant documents found and posted here, as well as all the clinical feedback given by a huge sample of people Dx with MC) this board has done much of the "heavy lifting" already.
Pat wrote:Is there some one or some institution that is doing research on MC?
Surely there is some research going on somewhere, but I have no idea where. Interestingly, when I Google the words "current research microscopic colitis", two of the top three hits are on this website, so apparently Ant and Gloria are on target.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Visit the Microscopic Colitis Foundation Website
