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Prise en charge des colites microscopiques

Management of microscopic colitis

  • Article Original / Original Article
  • Published:
Journal Africain d'Hépato-Gastroentérologie

Résumé

Introduction

Les colites microscopiques (CM) regroupent deux entités cliniques: la colite collagène (CC) et la colite lymphocytaire définies par des anomalies histologiques spécifiques. Elles constituent une cause commune de diarrhée aqueuse chronique survenant sur un colon d’aspect macroscopique normal.

Matériel et méthodes

Revue de la littérature

Résultats

L’incidence des CM a augmenté ces deux dernières décennies et est de l’ordre de 7–12 cas/100.000 habitants. L’étiologie est inconnue mais probablement multifactorielle. La clinique est faite essentiellement de diarrhée chronique survenant chez la femme âgée. Des maladies auto-immunes associées sont fréquentes. La coloscopie couplée aux biopsies coliques représente l’examen-clé du diagnostic positif. Une cause médicamenteuse est à rechercher de principe. Le budésonide constitue un traitement efficace à court terme sur le plan clinique, endoscopique et histologique. L’évolution est généralement bénigne hormis quelques rares complications.

Conclusion

Les aspects cliniques, et épidémiologiques des CM sont bien identifiés. La bénignité habituelle de la maladie justifie un traitement médicamenteux selon une stratégie progressive.

Cependant d’autres études prospectives à large spectre sont nécessaires afin d’optimiser le devenir et la prise en charge à long terme des patients atteints de CM.

Abstract

Introduction

Microscopic colitis (MC) includes two entities collagenous colitis (CC) and lymphocytic colitis (LC) characterized by histopathological features. It is a common cause of chronic watery diarrhoea with an endoscopically normal appearing colon.

Material and methods

Literature review

Results

Annual incidence has increased in the past two decades (7–12 cases/100000 persons). The aetiology is unknown and probably multifactorial. It’s characterized clinically by chronic diarrhoea and an association with autoimmune diseases especially in elderly female. Colonoscopy with appropriate biopsies allows for the diagnosis by histological analysis. Budesonide is effective in the short term and associated with a clinical, endoscopic and histological response. The long term prognosis of MC is good, serious complications are rare.

Conclusion

Clinical and epidemiological aspects of MC are well described. Based on the good outcome of MC, a stepwise approach to the treatment is suggested on which. Prospective observational and clinical trials are warranted to optimize the long term management of patients with MC.

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Authors and Affiliations

  1. Service de gastroentérologie B, Hôpital la Rabta, La Rabta, Tunis

    N. Naïja, B. Mohsni, N. Belkahla, N. Maamouri & N. Ben Mami

Authors
  1. N. Naïja
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  2. B. Mohsni
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  3. N. Belkahla
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  4. N. Maamouri
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  5. N. Ben Mami
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Corresponding author

Correspondence to N. Naïja.

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Naïja, N., Mohsni, B., Belkahla, N. et al. Prise en charge des colites microscopiques. J Afr Hepato Gastroenterol 6, 306–311 (2012). https://doi.org/10.1007/s12157-012-0421-4

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  • DOI: https://doi.org/10.1007/s12157-012-0421-4

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