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Microscopic Colitis and prescription drug use

Published 20 April 2015

A large research study has suggested that there may be a link between taking some medications and developing Microscopic Colitis.

This Danish study looked at a group of nearly 6,000 people - 3,474 people with Collagenous Colitis and 2,277 with Lymphocytic Colitis - and studied their use of prescription drugs.

It looked at four groups of medication: proton pump inhibitors (used to reduce acid), NSAIDS or ‘non steroidal anti-inflammatory drugs’ (such as ibuprofen and aspirin), statins (used to reduce cholesterol), and elective serotonin reuptake inhibitors (antidepressants).

The researchers found a positive association between the use of each of these four drug groups and a diagnosis of Microscopic Colitis. The links were strongest between the use of protein pump inhibitors and Collagenous Colitis, and between using anti-depressants and Lymphocytic Colitis. The link between taking NSAIDS or statins and developing MC was much weaker.

In their analysis the researchers noted several ways in which the results may have been affected, in particular differences in how often endoscopic samples were taken. They also pointed out that around a quarter of the people in this study had not taken any of these drugs, and that many other factors may have contributed to the development of
Microscopic Colitis.

In Microscopic Colitis (which has two main forms, Collagenous Colitis and Lymphocytic Colitis) the appearance of the bowel lining is usually normal to the naked eye when viewed through a colonoscope. However, when biopsies (tissue samples) are taken from the bowel lining and viewed under a microscope, distinctive changes to the bowel lining can be seen.

Source: Drug exposure and risk of microscopic colitis: a nationwide Danish case-control study with 5751 cases. Bonderup at et. Inflamm Bowel Dis. 2014 Oct;20(10):1702-7

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