Microscopic colitis has been in the news recently as a leading charity has raised concerns that thousands of people could be living with undiagnosed, debilitating bowel disease.

Around 17,000 people are diagnosed with microscopic colitis each year in the UK, but Guts UK say this figure doesn’t reflect the true number of people affected. The condition is often misunderstood by patients and medics, which leads to it being misdiagnosed or not diagnosed for many years. A third of people with symptoms of microscopic colitis are told they have irritable bowel syndrome (IBS) instead.

Sonia Parkes, a senior litigator at Medical Solicitors, is currently investigating the case of a woman whose microscopic colitis went undiagnosed and untreated for five years. The claimant’s colorectal expert incorrectly informed both our client and her GP that the colonoscopy biopsy results were normal when they in fact showed microscopic colitis was present.

Many of the tests used to detect other forms of IBD like Crohn’s disease and ulcerative colitis don’t work for microscopic colitis. Microscopic colitis affects the innermost lining of the bowel so it can sometimes appear normal under a colonoscopy. A poo test reading would also come back normal as the inflammation in the bowel is so microscopic.

It is therefore crucial that biopsies are taken from the bowel and examined under a microscope.

Failure to do so means people don’t receive the right treatment and continue to experience symptoms that are debilitating, embarrassing and seriously impact their quality of life. A correct diagnosis can make a huge difference to people’s lives.

What is microscopic colitis?

Microscopic colitis is a type of inflammatory bowel disease that affects the large bowel. Around 67,000 people in the UK have a diagnosis of microscopic colitis, with cases continuing to rise.

Women are 700 percent more likely to have microscopic colitis than men, and it is more common in people aged between 50-70. But it can affect anyone at any age.

Risk increases in people who smoke and it can be triggered by taking some medications like non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, antidepressants, omeprazole for acid, and statins for cholesterol.

As inflammatory bowel disease is an autoimmune disorder, people with microscopic colitis may have other autoimmune conditions like rheumatoid arthritis, psoriasis, coeliac disease, or type 1 diabetes.

What are the symptoms of microscopic colitis?

The main symptom is frequent watery diarrhoea, that being three or more extremely loose bowel movements a day for more than four weeks.

People with microscopic colitis find they need to constantly empty their bowels throughout the day and night, with some going to the toilet up to 40 times a day. Bowel movements are usually sudden or explosive, and patients may experience incontinence. This can cause anxiety around leaving the house and knowing there is a toilet close by to prevent any accidents. This inevitably impacts a person’s quality of life, affects their ability to work, and can leave them feeling isolated.

Other symptoms of microscopic colitis include stomach pain or cramping, fatigue and weight loss.

How is microscopic colitis treated?

Microscopic colitis is easily treated once diagnosed. This is usually with a gut-specific steroid such as budesonide or loperamide to control the inflammation. Sometimes, patients will be prescribed medication to relieve their symptoms.

As it is an autoimmune disorder, microscopic colitis cannot be cured. Patients will still continue to have flare ups and may still need to go to the toilet more than normal. But medication means these can be managed.

In the case currently being investigated by Sonia, her client went five years without treatment. During this time, it impacted many aspects of her life. She is being supported to make a clinical negligence claim for her pain and suffering that could have been avoidable had mistakes with her care not been made.

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Case being handled by

Sonia Parkes

Senior Litigator