Chronische diarree door microscopische colitis: Alertheid loont

The incidence of microscopic colitis (MC) in The Netherlands is increasing, yet the numbers are low compared to other countries. Awareness is likely to play a role. We describe two cases to illustrate the benefit of MC awareness among physicians and pathologists. In a 45-year-old female who presented with chronic diarrhoea, no cause could be identified despite extensive examinations in other hospitals. A biopsy revision, performed in our centre, revealed MC. Treatment with budesonide was immediately effective. A 76-year-old female with chronic diarrhoea was also diagnosed with MC. Because a relationship with NSAID use was suspected, the drug was withdrawn and the diarrhoea resolved. These cases illustrate that awareness of MC might accelerate the diagnosis of patients with chronic diarrhoea, consequently enabling the prescription of oral budesonide, a highly effective treatment. Some drugs are associated with an increased risk of MC. Withdrawal of these drugs could be another successful treatment strategy.