Microscopic colitis (MC) is an often-overlooked form of inflammatory bowel disease that causes urgent watery diarrhoea.
Diagnosis is easily missed by doctors because identification of the condition requires a a biopsy to be taken during a colonoscopy. Without the tissue examination in a lab, the bowel wall looks normal to the naked eye through the lens of a camera.
MC makes life very difficult for sufferers. Symptoms can be mistaken for IBS and include bloating and urgent daily bouts of diarrhoea with little or no warning.
Unlike the better-known forms of inflammatory bowel disease, ulcerative colitis and crohns disease, MC is benign and doesn’t predispose someone to bowel cancer.
There are two forms of the condition: collagenous colitis, where there is an extra thick layer of collagen supporting the intestinal wall, and lymphocytic colitis, where there is a build-up of white blood cells in the intestinal wall. Both are an inflammatory response triggered by the immune system, as a result of something it doesn’t like in the contents of the intestines.
Known triggers are smoking, non-steroidal anti-inflammatory drugs like Naproxen and Ibuprofen, PPI acid-lowering medication, gastrointestinal infections and hormonal changes. There’s a high rate of the disease in menopausal women.
MC can be managed through medication, dietary changes, learning to manage stress, and avoiding food triggers.
To learn more, you can read my article, ‘Microscopic colitis: a misunderstood inflammatory bowel disease‘, in the April 2026 edition of Network Health Dieticians (NHD magazine)
If you suffer from microscopic colitis and want to improve your symptoms and reduce diarrhoea, please get in touch.
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