From the Guidelines
Mucous stools can occur in microscopic colitis, although watery diarrhea is the predominant symptom. Microscopic colitis is characterized by chronic watery diarrhea caused by inflammation in the colon, diagnosed by colonic biopsy 1. The condition comprises two subtypes, lymphocytic colitis and collagenous colitis, with a reported prevalence ranging from 48 to 219 per 100,000 1. While the hallmark symptom of microscopic colitis is watery diarrhea, some patients may experience mucous discharge due to the inflammation in the colon's lining, which can cause increased secretion of fluid and sometimes mucus into the intestinal lumen.
Key Points to Consider
- Microscopic colitis is not associated with increased mortality, but symptoms can lead to impaired quality of life 1.
- The goal of medical therapy is to relieve symptoms and improve quality of life while minimizing drug-related adverse effects 1.
- Treatment typically includes anti-inflammatory medications, anti-diarrheal agents, or bile acid binders, and patients with refractory symptoms should avoid potential medication triggers such as nonsteroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors 1.
Important Considerations for Diagnosis and Treatment
- If you're experiencing mucous stools along with persistent diarrhea, it's essential to consult a gastroenterologist for proper diagnosis and treatment.
- The diagnosis of microscopic colitis requires a colonoscopy with biopsies of multiple segments of the colon, as the condition may not be visible during endoscopy 1.
- Coexisting causes of chronic diarrhea, such as celiac disease, should be considered in patients with ongoing symptoms despite medical therapy 1.
From the Research
Symptoms of Microscopic Colitis
- The clinical presentation of microscopic colitis is nonspecific and includes watery nonbloody diarrhea, nocturnal stools, fecal urgency, abdominal pain, arthralgias, and weight loss 2.
- Microscopic colitis typically presents as chronic or intermittent watery diarrhea, that may be accompanied by symptoms such as abdominal pain, weight loss and incontinence 3.
- The main symptom of microscopic colitis is watery diarrhoea without blood, other symptoms include defecatory urgency, faecal incontinence, abdominal pain, nocturnal bowel movements, and weight loss 4.
Mucous Stools in Microscopic Colitis
- There is no direct mention of mucous stools as a common symptom of microscopic colitis in the provided studies.
- However, the studies do mention that microscopic colitis is characterized by chronic watery diarrhea, which may be accompanied by other symptoms such as abdominal pain and weight loss 2, 5, 3, 6, 4.
Diagnosis and Treatment
- The diagnosis of microscopic colitis requires histologic assessment of colon biopsies with findings including increased in intraepithelial lymphocytes with or without expansion of the subepithelial collagen band 6.
- Treatment consists of budesonide oral (the gold standard) or enema, with alternatives including bile acid sequestrants, biologics, thiopurines, methotrexate, and rarely, surgery 4.
- Antidiarrheal medications, such as loperamide or bismuth subsalicylate, may be sufficient in patients with mild symptoms, while treatment with budesonide is recommended for patients with more severe symptoms 6.