Zum Hauptinhalt springen

Mikroskopische Kolitis

Zuletzt bearbeitet: Zuletzt revidiert:
Zuletzt revidiert von:


Definition:
Chronische Durchfallerkrankung mit typischen, histologisch nachweisbaren Schleimhautveränderungen. Unterschieden werden die Unterformen kollagene und lymphozytäre Kolitis.
Häufigkeit:
Etwa 9 Fälle je 100.000 Personen jährlich. 10–20 % der chronischen Durchfallerkrankungen, gehäuft betroffen sind ältere Frauen.
Symptome:
Symptom ist eine anhaltende, wässrige, unblutige Diarrhö.
Befunde:
Die klinischen Befunde sind normal. 
Diagnostik:
Wichtigste Untersuchung ist die Koloskopie mit Stufenbiopsien.
Therapie:
Absetzen von auslösenden Medikamenten wie NSAR and Protonenpumpenhemmern. Spontanremissionen sind häufig. Die Behandlung erfolgt mit Budenosid.
  1. Lindström CG. Collagenous colitis with watery diarrhea--a new entity? Pathol Eur 1976; 11: 87-89. PubMed  
  2. Haagen Nielsen O, Vainer B, Schaffalitzky de Muckadell OB. Microscopic colitis: a missed diagnosis?. Lancet 2004; 364: 2055-7. PubMed  
  3. Olesen M, Eriksson S, Bohr J, Järnerot G, Tysk C. Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Örebro, Sweden, 1993-1998. Gut. 2004 Mar;53(3):346-50. PubMed PMID: 14960513. PubMed  
  4. Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H,Madisch A, Munck LK, Ström M, Tysk C, Miehlke S; European Microscopic ColitisGroup (EMCG). Microscopic colitis: Current status, present and future challenges:statements of the European Microscopic Colitis Group. J Crohns Colitis. 2012Oct;6(9):932-45. Epub 2012 Jun 15. Review. PubMed PMID: 22704658. PubMed  
  5. Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: A systematic review and meta-analysis. Am J Gastroenterol. 2015 Feb;110(2):265-276 . doi:10.1038/ajg.2014.431 DOI  
  6. Loftus EV. Microscopic colitis: epidemiology and treatment. Am JGastroenterol. 2003 Dec;98(12 Suppl):S31-6. Review. PubMed PMID: 14697916. PubMed  
  7. Bohr J, Tysk C, Eriksson S, Abrahamsson H, Järnerot G. Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut 1996; 39: 846. Gut  
  8. Järnerot G, Tysk C, Bohr J, et al. Collagenous colitis and fecal stream diversion. Gastroenterology 1995; 109: 449-55. Gastroenterology  
  9. Park T, Cave D, Marshall C. Microscopic colitis: A review of etiology, treatment and refractory disease. World J Gastroenterol. 2015 Aug 7;21(29):8804-10. www.ncbi.nlm.nih.gov  
  10. Stewart MJ, Seow CH, Storr MA. Prednisolone and budesonide for short- andlong-term treatment of microscopic colitis: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2011 Oct;9(10):881-90. doi:10.1016/j.cgh.2011.06.005. Epub 2011 Jun 13. Review. PubMed PMID: 21699817. PubMed  
  11. Masclee GM, Coloma PM, Kuipers EJ, Sturkenboom MC. Increased risk ofmicroscopic colitis with use of proton pump inhibitors and non-steroidalanti-inflammatory drugs. Am J Gastroenterol. 2015 May;110(5):749-59. doi:10.1038/ajg.2015.119. Epub 2015 Apr 28. PubMed PMID: 25916221. PubMed  
  12. Fernández-Bañares F, de Sousa MR, Salas A, Beltrán B, Piqueras M, Iglesias E, Gisbert JP, Lobo B, Puig-Diví V, García-Planella E, Ordás I, Andreu M, Calvo M,Montoro M, Esteve M, Viver JM; RECOMINA Project, GETECCU Grupo Español deEnfermedades de Crohn y Colitis Ulcerosa. Epidemiological risk factors inmicroscopic colitis: a prospective case-control study. Inflamm Bowel Dis. 2013Feb;19(2):411-7. doi: 10.1002/ibd.23009. PubMed PMID: 23344243. PubMed  
  13. Pardi DS. Diagnosis and Management of Microscopic Colitis. Am J Gastroenterol.2017 Jan;112(1):78-85. doi: 10.1038/ajg.2016.477. Epub 2016 Nov 29. Review.PubMed PMID: 27897155. PubMed  
  14. Fine KD, Do K, Schulte K, et al. High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome. Am J Gastroenterol 2000; 74: 1974-82. PubMed  
  15. Matteoni CA, Goldblum JR, Wang N, et al. Celiac disease is highly prevalent in lymphocytic colitis. J Clin Gastroenterol 2001; 32: 225-27. PubMed  
  16. Green PH, Yang J, Cheng J, Lee AR, Harper JW, Bhagat G. An association betweenmicroscopic colitis and celiac disease. Clin Gastroenterol Hepatol. 2009Nov;7(11):1210-6. doi: 10.1016/j.cgh.2009.07.011. Epub 2009 Jul 22. PubMed PMID: 19631283. PubMed  
  17. Fernández-Bañares F, de Sousa MR, et al. Impact of current smoking on theclinical course of microscopic colitis. Inflamm Bowel Dis. 2013 Jun;19(7):1470-6.doi: 10.1097/MIB.0b013e318281f3cc. PubMed PMID: 23552765. PubMed  
  18. Vigren L, Sjöberg K, Benoni C, Tysk C, Bohr J, Kilander A, Larsson L, Ström M,Hjortswang H. Is smoking a risk factor for collagenous colitis? Scand JGastroenterol. 2011 Nov;46(11):1334-9. doi: 10.3109/00365521.2011.610005. Epub2011 Aug 19. PubMed PMID: 21854096. PubMed  
  19. Wildt S, Nordgaard-Lassen I, Bendtsen F, Rumessen JJ. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol 2007; 19: 567. PubMed  
  20. Bohr J, Tysk C, Yang P, Danielsson D, Järnerot G. Autoantibodies andimmunoglobulins in collagenous colitis. Gut. 1996 Jul;39(1):73-6. www.ncbi.nlm.nih.gov  
  21. Freeman HJ. Perinuclear antineutrophil cytoplasmic antibodies in collagenousor lymphocytic colitis with or without celiac disease. Can J Gastroenterol. 1997 Jul-Aug;11(5):417-20. PubMed PMID: 9286475. PubMed  
  22. Gentile N, Yen EF. Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis. Gut Liver. 2018 May 15;12(3):227-235. www.ncbi.nlm.nih.gov  
  23. Hjortswang H, Tysk C, Bohr J, Benoni C, Kilander A, Larsson L, Vigren L, StrömM. Defining clinical criteria for clinical remission and disease activity incollagenous colitis. Inflamm Bowel Dis. 2009 Dec;15(12):1875-81. doi:10.1002/ibd.20977. Epub 2009 Jun 5. PubMed PMID: 19504614. PubMed  
  24. Jaruvongvanich V, Poonsombudlert K, Ungprasert P. Smoking and Risk ofMicroscopic Colitis: A Systematic Review and Meta-analysis. Inflamm Bowel Dis.2019 Mar 14;25(4):672-678. doi: 10.1093/ibd/izy296. PubMed PMID: 30869794. PubMed  
  25. Münch A, Tysk C, Bohr J, Madisch A, Bonderup OK, Mohrbacher R, Mueller R,Greinwald R, Ström M, Miehlke S. Smoking Status Influences Clinical Outcome inCollagenous Colitis. J Crohns Colitis. 2016 Apr;10(4):449-54. doi:10.1093/ecco-jcc/jjv235. Epub 2015 Dec 30. PubMed PMID: 26721941. PubMed  
  26. Baert F, Schmit A, D'Haens G, Dedeurwaerdere F, Louis E, Cabooter M, De Vos M,Fontaine F, Naegels S, Schurmans P, Stals H, Geboes K, Rutgeerts P; Belgian IBDResearch Group; Codali Brussels. Budesonide in collagenous colitis: adouble-blind placebo-controlled trial with histologic follow-up.Gastroenterology. 2002 Jan;122(1):20-5. PubMed PMID: 11781276. PubMed  
  27. Bonderup OK, Hansen JB, Birket-Smith L, Vestergaard V, Teglbjaerg PS,Fallingborg J. Budesonide treatment of collagenous colitis: a randomised, double blind, placebo controlled trial with morphometric analysis. Gut. 2003Feb;52(2):248-51. PubMed PMID: 12524408 PubMed  
  28. Miehlke S, Heymer P, Bethke B, Bästlein E, Meier E, Bartram HP, Wilhelms G,Lehn N, Dorta G, DeLarive J, Tromm A, Bayerdörffer E, Stolte M. Budesonidetreatment for collagenous colitis: a randomized, double-blind,placebo-controlled, multicenter trial. Gastroenterology. 2002 Oct;123(4):978-84. PubMed PMID: 12360457. PubMed  
  29. Miehlke S, Madisch A, Karimi D, Wonschik S, Kuhlisch E, Beckmann R, Morgner A,Mueller R, Greinwald R, Seitz G, Baretton G, Stolte M. Budesonide is effective intreating lymphocytic colitis: a randomized double-blind placebo-controlled study.Gastroenterology. 2009 Jun;136(7):2092-100. doi: 10.1053/j.gastro.2009.02.078.Epub 2009 Mar 17. PubMed PMID: 19303012. PubMed  
  30. Chande N, Al Yatama N, Bhanji T, Nguyen TM, McDonald JW, MacDonald JK.Interventions for treating lymphocytic colitis. Cochrane Database Syst Rev. 2017 Jul 13;7:CD006096. doi: 10.1002/14651858.CD006096.pub4. Review. PubMed PMID:28702956. PubMed  
  31. Kafil TS, Nguyen TM, Patton PH, MacDonald JK, Chande N, McDonald JW. Interventions for treating collagenous colitis. Cochrane Database Syst Rev. 2017 Nov 11;11:CD003575. Review. PubMed PMID: 29127772. PubMed  
  32. Miehlke S, Madisch A, Voss C, et al. Long-term follow-up of collagenous colitis after induction of clinical remission with budesonide. Aliment Pharmacol Ther 2005; 22: 1115. PubMed  
  33. Olesen M, Eriksson S, Bohr G, et al. Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients. Gut 2004 Apr;54(4):536-41. www.ncbi.nlm.nih.gov  
  34. Goldstein NS, Gyorfi T. Focal lymphocytic colitis and collagenous colitis: patterns of Crohn's colitis? Am J Surg Pathol 1999; 23: 1075-81. PubMed  
  35. Pokorny CS, Kneale KL, Henderson CJA. Progression of collagenous colitis to ulcerative colitis. J Clin Gastroenterol 2001; 32: 435-38. PubMed  
  36. Chan JL, Tersmette AC, Offerhaus JA, et al. Cancer risk in collagenous colitis. Inflam Bowel Dis 1999; 5: 40-43. PubMed  
  • Dietrich August, Arzt in Weiterbildung, Freiburg i. Br.
  • Terje Johannessen, professor i allmennmedisin, Institutt for samfunnsmedisinske fag, Norges teknisk-naturvitenskapelige universitet, Trondheim
  • Jan H. Dybdahl, Oberarzt, Dr. med., Medizinische Abteilung, St. Olavs-Hospital, Trondheim