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Diagnosing Lymphocytic Colitis

A diagnosis is typically made after tissue samples taken during colonoscopy or flexible sigmoidoscopy are examined under a microscope. In lymphocytic colitis, tissue samples show inflammation, with white blood cells known as lymphocytes between the cells that line the colon. In contrast to collagenous colitis, there is no abnormality of the collagen protein.
People with lymphocytic colitis are generally diagnosed in their 50s. Both men and women are equally affected with this condition.

Treatment Options

Treatment for lymphocytic colitis varies, depending on the symptoms and severity of the disease. The disease has been known to resolve on its own, but most people have recurrent symptoms.
Lifestyle changes aimed at improving diarrhea are usually tried first. Recommended changes include:
  • Reducing the amount of fat in the diet
  • Eliminating foods that contain caffeine or lactose
  • Not using NSAIDs.
If lifestyle changes alone are not enough, medications are often used to control symptoms.
Antidiarrheal medications (such as bismuth subsalicylate) and bulking agents (such as fiber supplements) can help reduce diarrhea. Anti-inflammatory medications, such as mesalamine, sulfasalazine, and steroids (including budesonide), reduce inflammation. Immunosuppressive agents, which reduce the autoimmune response, are rarely needed.
For extreme cases of lymphocytic colitis, bypass of the colon or surgery to remove all or part of the colon has been done on occasion. However, these surgeries are rarely recommended.
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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