Living with chronic diarrhea and digestive discomfort can be frustrating and disruptive. When you don’t know what’s causing it, things get even more complicated. One condition that often goes unnoticed is microscopic colitis, a type of inflammation in the colon that leads to persistent diarrhea. Unlike other digestive issues, it doesn’t show up on standard imaging tests and can only be diagnosed through a biopsy under a microscope.
That’s how it got its name. Even though it’s not as well-known as other gut disorders, microscopic colitis can have a big impact on daily life. If you don’t treat the symptoms, it can get worse and can make everyday activities difficult.
The positive side is that with the right approach, including diet changes, medications, and lifestyle adjustments, it’s manageable. In this blog, we’ll break down the signs of microscopic colitis and what you can do to manage it effectively. Whether you’ve already been diagnosed or you’re just looking for answers, this guide will help you take charge of your digestive health.
What is Microscopic Colitis?
Microscopic colitis is a type of inflammatory bowel disease (IBD) that affects the colon (large intestine). It is characterized by inflammation that is visible only under a microscope, hence the term microscopic. There are two main types of microscopic colitis: lymphocytic colitis and collagenous colitis. Both types lead to similar symptoms, but they have different patterns of inflammation.
The exact cause of microscopic colitis remains unclear, but it’s believed to be related to autoimmune responses, infections, and environmental triggers. The condition can occur at any age, but it is most common in older adults, particularly women.
The Link Between Microscopic Colitis and Persistent Diarrhea
The link between microscopic colitis and persistent diarrhea is direct, as chronic, watery diarrhea is the primary symptom of this condition. Here’s how they are connected:
1. Inflammation of the Colon Lining
The main reason for persistent diarrhea in microscopic colitis is the inflammation of the colon lining. When the colon is inflamed, it can’t absorb water properly from the food you’ve digested. This causes food to move through the colon too quickly, leading to watery stools. The inflammation can also mess with the balance of good bacteria in your gut, making the diarrhea worse. In severe cases, the stool moves so quickly through the colon that the body doesn’t have enough time to absorb important nutrients and electrolytes, which results in the frequent, watery bowel movements that are common with chronic diarrhea.
2. Altered Bowel Motility
Inflammation in the colon can also mess with how the muscles in the digestive tract move food and waste. In people with microscopic colitis, the muscles in the colon may contract unevenly, causing food and waste to move too fast. This doesn’t give the body enough time to absorb water and nutrients properly.
Sometimes, this can cause both diarrhea and constipation to alternate, making the symptoms harder to manage. People with microscopic colitis often go through phases of diarrhea and then chronic constipation, which can be hard to manage. This back-and-forth can make it hard to predict when symptoms will flare up, adding to the discomfort.
3. Loss of Absorptive Capacity
The colon is responsible for absorbing water, nutrients, and electrolytes from waste before it’s excreted. In microscopic colitis, the inflammation in the colon makes it hard for the body to do this properly. As a result, more liquid stays in the stool, causing diarrhea.
This symptom sticks around because the colon remains inflamed, and it can’t absorb water properly until the inflammation is treated. If the inflammation doesn’t go away, the diarrhea can continue, making it tough to have regular bowel movements. Over time, if left unchecked, this disruption can lead to more issues.
4. Immunological Response
Microscopic colitis is often linked to an autoimmune disorder, where the immune system mistakenly attacks the cells in the colon lining, causing inflammation. This triggers the release of chemicals that irritate the colon, making diarrhea worse.
Since this immune response can go on for a long time, it leads to ongoing symptoms, including diarrhea that doesn’t go away easily. The constant immune activity keeps the colon from healing, which makes it harder to manage the condition. Without proper treatment, this cycle of inflammation continues, making symptoms even tougher to control.
5. Medications and Other Triggers
In some cases, microscopic colitis can be triggered or made worse by medications like NSAIDs, proton pump inhibitors (PPIs), or certain antibiotics. These drugs can irritate the colon, worsening diarrhea. For people already prone to the condition, these medications may make symptoms worse and lead to persistent diarrhea.
Other factors like infections, certain foods, and stress can also contribute to ongoing diarrhea. Identifying and avoiding these triggers is an important part of managing the condition and improving quality of life.
Ways to Manage Persistent Diarrhea from Microscopic Colitis
While there is no cure for Microscopic Colitis, there are several approaches to manage and reduce the persistent diarrhea associated with the condition.
1. Medication
Doctors may suggest anti-inflammatory drugs like budesonide to reduce inflammation in the colon. Sometimes, medications like antidiarrheal drugs can help by slowing down bowel movements and cutting down on diarrhea.
Other medicines may help control the immune system, preventing it from attacking the colon lining. For more serious cases, doctors might recommend immune-suppressing drugs to control inflammation and symptoms.
2. Dietary Adjustments
Changing your diet can really help manage persistent diarrhea from microscopic colitis. Avoiding foods that irritate the colon, like spicy or fatty foods and dairy, can reduce symptoms. A low-fiber or easy-to-digest diet can also give your colon a break and help with digestion.
Eating smaller meals more often throughout the day can prevent overloading your digestive system. It’s also important to stay hydrated and replace lost electrolytes, as diarrhea can lead to dehydration.
3. Hydration
Chronic diarrhea can quickly lead to dehydration, so it is essential to drink plenty of fluids. Oral rehydration solutions, which contain electrolytes, can help maintain proper hydration levels and prevent complications such as fatigue and weakness.
You can also try drinking clear broths, herbal teas, and coconut water to stay hydrated. Regularly sipping on fluids throughout the day will help ensure you’re getting enough to replace what’s lost during diarrhea.
4. Stress Management
Stress can significantly impact gastrointestinal health, and Microscopic Colitis is no exception. Managing stress through techniques like meditation, deep breathing, yoga, or mindfulness can help reduce flare-ups and improve overall well-being.
Regular physical activity can also help release tension and support gut health. Creating a calming routine or finding activities that help you relax can make a big difference in managing symptoms.
Get Expert Care to Find Relief from Microscopic Colitis
Microscopic Colitis is an inflammatory condition that can cause persistent diarrhea due to inflammation of the colon lining, altered bowel motility, and loss of absorptive capacity. While it can be challenging to manage, especially when symptoms persist, it is possible to find relief with the right approach, including medication, dietary adjustments, and stress management. If you suspect that Microscopic Colitis is causing your chronic diarrhea, consult a gastroenterologist in South Africa for a proper diagnosis and treatment plan to manage the condition and improve your quality of life.