European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations

Stephan Miehlke*, Danila Guagnozzi, Yamile Zabana, Gian E. Tontini, Anne-Marie Kanstrup Fiehn, Signe Wildt, Johan Bohr, Ole Bonderup, Gerd Bouma, Mauro D'Amato, Peter Johan Heiberg Engel, Fernando Fernandez-Banares, Gilles Macaigne, Henrik Hjortswang, Elisabeth Hultgren-Hornquist, Anastasios Koulaouzidis, Jouzas Kupcinskas, Stefania Landolfi, Giovanni Latella, Alfredo LucendoIvan Lyutakov, Ahmed Madisch, Fernando Magro, Wojciech Marlicz, Emese Mihaly, Lars Kristian Munck, Ann-Elisabeth Ostvik, Arpad Patai, Plamen Penchev, Karolina Skonieczna-Zydecka, Bas Verhaegh, Andreas Munch

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Introduction Microscopic colitis is a chronic inflammatory bowel disease characterised by normal or almost normal endoscopic appearance of the colon, chronic watery, non-bloody diarrhoea and distinct histological abnormalities, which identify three histological subtypes, the collagenous colitis, the lymphocytic colitis and the incomplete microscopic colitis. With ongoing uncertainties and new developments in the clinical management of microscopic colitis, there is a need for evidence-based guidelines to improve the medical care of patients suffering from this disorder. Methods Guidelines were developed by members from the European Microscopic Colitis Group and United European Gastroenterology in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument. Following a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the certainty of the evidence. Statements and recommendations were developed by working groups consisting of gastroenterologists, pathologists and basic scientists, and voted upon using the Delphi method. Results These guidelines provide information on epidemiology and risk factors of microscopic colitis, as well as evidence-based statements and recommendations on diagnostic criteria and treatment options, including oral budesonide, bile acid binders, immunomodulators and biologics. Recommendations on the clinical management of microscopic colitis are provided based on evidence, expert opinion and best clinical practice. Conclusion These guidelines may support clinicians worldwide to improve the clinical management of patients with microscopic colitis.

Original languageEnglish
Article number2050640620951905
Pages (from-to)13-37
Number of pages25
JournalUnited European Gastroenterology Journal
Volume9
Issue number1
Early online date20 Aug 2020
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Microscopic colitis
  • inflammatory bowel disease
  • diarrhoea
  • budesonide
  • PLACEBO-CONTROLLED TRIAL
  • QUALITY-OF-LIFE
  • NONSTEROIDAL ANTIINFLAMMATORY DRUGS
  • SUBEPITHELIAL COLLAGEN TABLE
  • IRRITABLE-BOWEL-SYNDROME
  • PUMP INHIBITOR USE
  • LYMPHOCYTIC-COLITIS
  • DOUBLE-BLIND
  • CHRONIC DIARRHEA
  • RISK-FACTORS

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