A health condition that is one of two primary types of microscopic colitis, which can be detected only under a microscope, is called lymphocytic colitis. It often causes long-term (chronic) inflammation in the colon and a high density of inflammatory white blood cells (lymphocytes).
Furthermore, microscopic colitis is a type of inflammatory bowel disease (IBD), which is a chronic disorder that causes inflammation in the intestines. Usually, doctors recognize different types of microscopic colitis by examining the intestinal lining. Typically, lymphocytic colitis is characterized by an abnormal level of white blood cells in the intestinal lining. Most of the time, high levels of lymphocytes occur when the immune system fights an infection. However, in people with lymphocytic colitis, there is no infection.
Is Lymphocytic Colitis an Autoimmune Disorder?
Most scientists believe that all inflammatory bowel diseases are autoimmune disorders. These conditions cause chronic inflammation in several parts of the body when there is no infection. It happens when the immune system mistakenly attacks healthy cells instead of bacteria, viruses, and other germs that can make you ill.
What Are The Symptoms of Lymphocytic Colitis?
People who develop this condition usually experience the following symptoms. Examples include:
- Frequent, watery diarrhea
- Abdominal pain (about 50% of people with this condition have this symptom)
- Fecal incontinence
- Dehydration
- Unusual weight loss
- Extreme tiredness (fatigue)
Commonly, people with this autoimmune condition may also have other autoimmune disorders, which can cause other symptoms. The most common secondary symptoms in people with lymphocytic colitis include uveitis (eye inflammation), psoriasis, and arthritis.
Causes and Risk Factors
This health condition occurs due to long-term inflammation in the colon. It causes cellular changes that lead to chronic diarrhea. Healthcare providers do not fully understand what exactly causes this disorder. Most of them believe that lymphocytic colitis happens due to a combination of factors. Check some examples below:
- Genetic changes
- Other autoimmune disorders – Approximately 40% of people with lymphocytic colitis also have one of the following autoimmune disorders. For example, celiac disease, type 1 diabetes, rheumatoid arthritis, or thyroid disease.
- Some environmental stress factors
- Age – Usually, this condition occurs in people over 65 years old.
- Sex – Lymphocytic colitis affects females more commonly.
- Smoking
What Are The Long-Term Effects of Lymphocytic Colitis?
People who develop this condition may also experience the following complications, especially if it is poorly managed. Check some examples below:
- Other autoimmune conditions – While other autoimmune disorders can cause lymphocytic colitis, it also increases the risk of the following conditions. These include Crohn’s disease, ulcerative colitis, type 1 diabetes, celiac disease, and others.
- Joint and skin inflammation – There are some people who experience arthritis (including joint stiffness and pain) or inflammatory skin rashes.
- Ocular inflammation
- Electrolyte imbalances
- Malabsorption and malnutrition
This document does not contain all possible complications of lymphocytic colitis. In any case, doctors may recommend some ways to reduce the risk or even prevent them. In addition, it is not possible to prevent this condition because doctors do not fully understand what exactly causes it.
Diagnosis
In some cases, this condition can be diagnosed by performing a biopsy. During this procedure, doctors will remove a small sample of affected tissue and test it under a microscope. This sample is often taken during a colonoscopy. Most of the time, colonoscopy is normal in people with lymphocytic colitis, but biopsies may reveal inflammation and an increased amount of lymphocytes. Your doctor may also perform additional tests (such as blood tests or stool tests) to rule out other conditions that cause similar symptoms to lymphocytic colitis.
Treatment
Doctors often recommend different treatments for people with lymphocytic colitis. While some people notice improvements with over-the-counter (OTC) medicines, others need prescription medications to manage this disorder. Usually, the treatment is based on the severity of the condition, existing health problems, sex, age, and preferences. Check below some medicines that are often prescribed by doctors for people with lymphocytic colitis:
- Over-the-counter (OTC) drugs – For example, Loperamide or Diphenoxylate to treat diarrhea.
- Bismuth Subsalicylate – This medicine is often taken several times per day.
- Budesonide – Doctors usually recommend this medication to reduce inflammation.
- Bile acid sequestrants – Commonly, physicians prescribe Colesevelam or Colestipol to treat some forms of diarrhea present in people with lymphocytic colitis.
Frequently Asked Questions
Is lymphocytic colitis curable?
Unfortunately, this condition cannot be cured, but it may go into remission. It means you no longer have symptoms. However, lymphocytic colitis always returns. Generally, the treatment goal is to reduce inflammation, prevent life-threatening complications, and improve your quality of life.
How serious is lymphocytic colitis?
This is a serious autoimmune condition that causes long-term inflammation in the colon, which is the last part of the GI (gastrointestinal) tract. The symptoms it causes may negatively affect your quality of life.
What type of diet is best for people with lymphocytic colitis?
Usually, doctors recommend avoiding some foods that trigger the symptoms of this condition (such as diarrhea). The following list does not contain all possible foods that can cause symptoms. The most common foods include:
- Caffeine
- Alcohol
- Gluten
- Dairy products
- Artificial sweeteners
- High-fiber and high-fat foods
In some cases, physicians may also recommend a BRAT diet, which stands for bananas, rice, applesauce, and toast.
Can lymphocytic colitis come and go?
Yes. Lymphocytic colitis often has a relapsing-remitting course, meaning symptoms may improve for weeks or months and then return. Some people experience long symptom-free periods (remission), while others have more frequent flare-ups.
Is lymphocytic colitis the same as ulcerative colitis or Crohn’s disease?
No. Although all are forms of inflammatory bowel disease (IBD), lymphocytic colitis is a type of microscopic colitis and differs from Crohn’s disease and ulcerative colitis. Unlike those conditions, the colon often appears normal during colonoscopy in lymphocytic colitis, and diagnosis requires biopsy.
What triggers flare-ups of lymphocytic colitis?
Common triggers may include certain medications (such as NSAIDs, proton pump inhibitors, or some antidepressants), smoking, caffeine, alcohol, and specific foods. However, triggers vary widely between individuals.
Can medications cause lymphocytic colitis?
Yes. Some medications have been associated with an increased risk of developing or worsening lymphocytic colitis. These may include nonsteroidal anti-inflammatory drugs (NSAIDs), certain diabetes medications, and acid-reducing drugs. Always consult a doctor before stopping any prescribed medication.
Does lymphocytic colitis increase the risk of colon cancer?
Current evidence suggests that lymphocytic colitis does not significantly increase the risk of colon cancer. However, ongoing symptoms should still be monitored to rule out other gastrointestinal conditions.
Can stress make lymphocytic colitis worse?
Stress does not cause lymphocytic colitis directly, but it may worsen symptoms in some individuals. Stress management techniques such as relaxation exercises, sleep improvement, and behavioral therapy may help reduce flare severity.
Is surgery ever needed for lymphocytic colitis?
Surgery is very rarely required. Most people respond to dietary changes and medications. Surgery is only considered in extremely severe, treatment-resistant cases, which are uncommon. If you have any other questions, ask your healthcare provider.
