Practical approach to microscopic colitis and inflammatory bowel disease

Microscopic colitis is a disease characterized by chronic, watery diarrhea, while diarrhea is usually bloody in ulcerative colitis and bloody or watery in Crohn's disease. Abdominal pain is common in microscopic colitis and IBD. Systemic manifestations, such as fever and aphthous mouth ulcers, are uncommon in microscopic colitis but common in IBD. Perianal and fistulizing conditions are seen almost exclusively in Crohn's disease. The clinical course and natural history of microscopic colitis is relatively benign and the disease is not associated with increased mortality or risk for colorectal cancer. On the other hand, IBD is characterized by recurrent episodes of inflammation, often associated with morbidity, and complications can lead to serious consequences. Crohn's colitis and ulcerative colitis are both associated with increased risk for colorectal cancer. Some therapies are effective for both microscopic colitis and IBD, while others seem to be more specific for microscopic colitis or IBD, based on currently available data.