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Microscopic Colitis Increases the Risk of Late-Onset IBD

Monika Fischer, MD, FASGE

Monika Fischer, MD, reviewing Khalili H, et al. Gastroenterology 2020 Jan 8.

In a nationwide Swedish cohort study, the diagnosis of microscopic colitis (N=14,000) was associated with a 17-fold increased risk of developing late-in-life–onset IBD compared to the general population, with mean lead times of 3.3 ± 3.2 years to Crohn’s disease (CD) diagnosis and 3.2 ± 3.5 years to ulcerative colitis (UC) diagnosis. The 10-year absolute excess risks of CD and UC were 0.9 (95% confidence interval [CI], 0.7-1.1) and 2.6 (95% CI, 2.2-2.9) percentage points, respectively.

COMMENT
These results suggest a link between microscopic colitis and late-onset IBD; however, the common pathway in pathogenesis still needs further exploration. While the prevalence of IBD in patients with microscopic colitis is low overall (2.7%), it is significantly higher than in individuals without microscopic colitis history (0.2%; odds ratio, 13.8). Therefore, we should consider the potential diagnosis of new-onset IBD in microscopic colitis patients who experience symptomatic relapse after successful treatment in the past, or in those who remain symptomatic despite long-term budesonide or alternative immunosuppressive therapy.

Monika Fischer, MD, FASGE

CITATION(S )

Khalili H, Burke KE, Roelstraete B, Sachs MC, Olén O, Ludvigsson JF. Microscopic colitis and risk of inflammatory bowel disease in a nationwide cohort study. Gastroenterology 2020 Jan 8. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2019.12.028)

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