Hi Shar,
Those of us who have been dealing with MC for 10 or 15 years or more find mistaken beliefs such as that to be clear evidence of how poorly MC is understood my many in the medical profession. Chapter 4 of my book begins with the following paragraphs:
Approximately 20 years after microscopic colitis was first described, some researchers suggested that it might be unnecessary to use medications to treat the disease, based on conclusions reached in studies that showed that the disease normally follows a benign course, and that symptoms often resolve, even without treatment, after a few years. Anyone who does a search of the literature will find many sources that repeat that claim, insisting that microscopic colitis is self-limiting, and the symptoms will resolve, with or without any medical intervention, after a period of several years, implying that the disease will go into long-term remission with or without treatment.
It appears that this mistaken belief is so ubiquitous in the literature, that for a time, at least, a majority of gastroenterologists were misled into accepting it as truth. Apparently, some still believe it to be true. The source of this misconception can usually be traced to one or both of two followup studies that showed that most cases of MC resolved with or without treatment, within an average period of slightly over three years. In one study of a group of patients with collagenous colitis, (published in 1997), it was concluded that 63 % of the group had “lasting resolution of symptoms after a mean 3.5 year follow-up”.1
In another study of a group of patients with lymphocytic colitis, (published in 1998), the data showed that diarrhea was no longer a symptom for fully 93 % of the group, and examination of biopsy samples showed that their intestinal epithelial cells had returned to normal, in 82 % of cases, by the end of a period of an average of 38 months after the initial onset of the disease.2
Note that in the research study published in 1998, the researchers did their followup examinations with a sigmoidoscope, rather than with a colonoscope, and they justified that procedure by claiming that with lymphocytic colitis, the intraepithelial lymphocyte count does not vary between the different segments of the colon, implying that biopsy samples taken from the rectum and sigmoid colon by using a sigmoidoscope can be considered to be accurately representative of the entire colon. As mentioned in the previous chapter, that claim has been disputed by subsequent research studies, that showed that at least 10 % of cases are typically missed when a sigmoidoscope is used.3
In addition, while the researchers did not clearly define the selection criteria used to pick the subjects in their study, a close examination of the article suggests that they may possibly have used some form of selection bias. It appears that they may have preferentially selected subjects who experienced sudden onset of symptoms, thereby excluding subjects who had been dealing with diarrhea issues for years. Experience shows that sudden onset of diarrhea is often associated with drug-induced microscopic colitis, that we know can often be resolved simply by discontinuing use of the drug that caused the inflammation. By being so selective, they ended up with only 27 patients on which to base their study, so it’s not surprising that they were able to reach such an unrealistic conclusion. The other research study that was cited, involving patients with collagenous colitis, only looked at 31 cases, so again, this raises the question of possible selection bias or some other form of creative data manipulation, that might have played a critical role in leading to conclusions so divergent from the real life experiences of the vast majority of patients living with MC.
And here are the references from that quote:
1. Goff, J. S., Barnett, J. L., Pelke, T., & Appelman, H. D. (1997). Collagenous colitis: Histopathology and clinical course. American Journal of Gastroenterology, 92(1), 57–60. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/8995938
2. Mullhaupt, B., Güller, U., Anabitarte, M., Güller, R., & Fried, M. (1998). Lymphocytic colitis: Clinical presentation and long term course. Gut, 43(5), 629–633. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/article ... p00629.pdf
3. Nielsen, O. H., Vainer, B., & Schaffalitzky de Muckadell, O. B. (2004). Microscopic colitis: a missed diagnosis? Lancet, 364(1), 2055–2057. Retrieved from
http://www.med.upenn.edu/gastro/documen ... olitis.pdf
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And my jaw dropped!! After I picked my jaw up and stopped reading, I thought I'd share this "wonderful" news with y'all. I'm almost at the 38 month mark! Yeahhhhhhhhhh!!
Having a bit of a flare of the flare I wrote to you about in May. Haven't done anything different, still eating bland and still GF, SF, DF, & EF, but not "D-Free", sad to say. Any words of wisdom about this greatly appreciated too. 
