Risk Factors for Microscopic Colitis
| Status: | Recruiting |
|---|---|
| Conditions: | Colitis |
| Therapuetic Areas: | Gastroenterology |
| Healthy: | No |
| Age Range: | 35 - Any |
| Updated: | 11/14/2018 |
| Start Date: | May 2016 |
| End Date: | December 2021 |
| Contact: | Robert S. Sandler, MD |
| Email: | rsandler@med.unc.edu |
| Phone: | 919-966-0090 |
Microscopic colitis is a common cause of watery diarrhea, particularly in the elderly.
Although the incidence is comparable to ulcerative colitis and Crohn's disease, the etiology
is unknown. Understanding the etiology of microscopic colitis is an important step in
developing logical interventions to decrease the burden from microscopic colitis. This
research could provide critical insights into the etiology of this poorly studied condition.
Although the incidence is comparable to ulcerative colitis and Crohn's disease, the etiology
is unknown. Understanding the etiology of microscopic colitis is an important step in
developing logical interventions to decrease the burden from microscopic colitis. This
research could provide critical insights into the etiology of this poorly studied condition.
Microscopic colitis (MC) is a chronic condition that is a common cause of watery diarrhea,
particularly in the elderly. The etiology is unknown but widely considered to be an abnormal
immune reaction to luminal antigens in predisposed hosts. Drugs and autoimmunity have also
been implicated. The aims of the study are: 1) To quantitatively classify microscopic colitis
using image analysis microscopy to determine whether the degree of lymphocytic infiltration
correlates with etiology, symptoms and prognosis. 2) To investigate the etiology of
microscopic colitis by examining medical and lifestyle risk factors including medications,
autoimmunity, diet, and smoking 3) To evaluate the association between the adherent microbial
flora and MC to assess whether bacterial dysbiosis is linked to presence of MC. As an
exploratory aim we will evaluate whether CYP2C19 polymorphisms are more common in purportedly
drug-induced disease since the diverse drugs that have been associated with MC are all
substrates for this gene.
To conduct the study the investigators will obtain detailed dietary, medical and lifestyle
information on study subjects who undergo complete colonoscopy for diarrhea. The
investigators will obtain colon biopsies from the right, transverse and left colon to
evaluate adherent bacterial organisms. The investigators will draw blood to evaluate CYP2C19
polymorphisms and for future genetic studies. The prospective design corrects important
limitations of prior research on MC. Successful completion of the study aims will improve the
understanding of risk factors, set the stage for more scientifically grounded future
research, and potentially suggest new interventions for a disease that is currently poorly
understood.
particularly in the elderly. The etiology is unknown but widely considered to be an abnormal
immune reaction to luminal antigens in predisposed hosts. Drugs and autoimmunity have also
been implicated. The aims of the study are: 1) To quantitatively classify microscopic colitis
using image analysis microscopy to determine whether the degree of lymphocytic infiltration
correlates with etiology, symptoms and prognosis. 2) To investigate the etiology of
microscopic colitis by examining medical and lifestyle risk factors including medications,
autoimmunity, diet, and smoking 3) To evaluate the association between the adherent microbial
flora and MC to assess whether bacterial dysbiosis is linked to presence of MC. As an
exploratory aim we will evaluate whether CYP2C19 polymorphisms are more common in purportedly
drug-induced disease since the diverse drugs that have been associated with MC are all
substrates for this gene.
To conduct the study the investigators will obtain detailed dietary, medical and lifestyle
information on study subjects who undergo complete colonoscopy for diarrhea. The
investigators will obtain colon biopsies from the right, transverse and left colon to
evaluate adherent bacterial organisms. The investigators will draw blood to evaluate CYP2C19
polymorphisms and for future genetic studies. The prospective design corrects important
limitations of prior research on MC. Successful completion of the study aims will improve the
understanding of risk factors, set the stage for more scientifically grounded future
research, and potentially suggest new interventions for a disease that is currently poorly
understood.
Inclusion Criteria:
Colonoscopy for diarrhea
Exclusion Criteria:
1. Fewer than 4 loose bowel movements per day.
2. Failure to visualize the entire colon to the cecum or preparation less than good or
excellent.
3. Age under 35 years. There will be no upper age limit.
4. Inability to understand and cooperate with the interview.
5. Indication for colonoscopy other than diarrhea.
6. Prior history of inflammatory bowel disease (Crohn's disease or ulcerative colitis).
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