A recent study published in the journal Gastro Hep Advances highlights several challenges faced by patients with microscopic colitis, an inflammatory digestive disease, including diagnostic uncertainty, inadequate treatment, and persistent symptoms one year after colonoscopy.
The study, led by Dr. Walker Redd, MD at the UNC School of Medicine, involved a cohort of patients enrolled at UNC Hospitals in Chapel Hill, NC, from April 1, 2015, to December 22, 2020.
The research aimed to better understand the symptom burden and diagnostic challenges faced by patients with microscopic colitis, particularly in comparison to patients experiencing other causes of chronic diarrhea after colonoscopy.
Key findings from the study include:
Diagnostic Awareness: Approximately 10% of patients with biopsy-confirmed microscopic colitis were unaware of their diagnosis, while 15% of control patients either believed they had microscopic colitis or were uncertain of their diagnosis.
Communication Gaps: While most patients with a new diagnosis of microscopic colitis received pathology results, the study emphasized the importance of clear communication regarding next steps and treatment options.
Treatment Disparities: Only 46% of patients with microscopic colitis received budesonide, the first-line therapy recommended for the condition. Additionally, just 26% of diarrhea control patients with significant symptoms were offered prescription treatment, indicating potential undertreatment.
Persistent Symptoms: Many patients with microscopic colitis continued to experience ongoing symptoms such as loose stools, urgency, abdominal pain, weight loss, and fecal incontinence at the one-year follow-up. In contrast, a smaller percentage of control patients reported symptom improvement.
Symptom Overlap: There is significant symptom overlap between microscopic colitis and other causes of chronic diarrhea, making it challenging for healthcare providers to distinguish between them. Colonoscopy should be considered for certain patients with unresponsive or high-risk chronic diarrhea.
The study’s findings underscore the need for clear communication of diagnostic results, follow-up appointments, patient education, and tailored treatment plans to empower individuals diagnosed with microscopic colitis and improve their symptom management.
Additionally, addressing the substantial symptom overlap with other conditions, such as irritable bowel syndrome, can aid in accurate diagnoses and appropriate treatments.
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The research findings can be found in Gastro Hep Advances.
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