I was doing a little thinking today, (I know - a dangerous thing to do), about food intolerances, and why some of us have such a tough time achieving remission. We generally think of MC as an issue that primarily affects the colon. After all, a diagnosis is based on biopsies from the colon, and the condition of the small intestine is considered to be pretty much irrelevant to a diagnosis of MC. However, according to research, fully 70% of MC patients also have inflammation in their small intestine, (which, of course, is the center of trouble for celiacs). (I'm guessing that biopsies of the colon were selected as a basis for diagnosis, primarily because of convenience, (since it is easier to obtain biopsy samples from the colon).
This is from:In patients with the microscopic colitis syndrome, serological tests for celiac sprue were weakly positive in 17%; mild inflammation of the small intestine without villous atrophy was present in 43%, and inflammation plus partial or subtotal villous atrophy was present in 27%.
http://www.ncbi.nlm.nih.gov/sites/entre ... med_DocSum
which is a research article published by Dr. Fine, and Mike was kind enough to post this link in another topic:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=2645
where we were discussing Enterolab Results for HLA-DQ Gene Molecular Analysis.
That being the case, MC patients are almost as likely to accumulate damage to the small intestine as celiacs. Not only that, but, as Alice pointed out in that other thread, damage can be accumulating, even though no outward symptoms are present.
I'm just guessing here, but I suspect this may be the reason why some of us can test positive to a certain food, and yet not show any obvious symptoms, (as Bob mentioned, in the thread referenced above, about casein intolerance - IOW, casein doesn't appear to bother him, even though he tested intolerant to it). I further suspect that this may explain why diet alone is sometimes not sufficient to bring remission, and that this may be why some of us have needed to resort to a med such as Entocort, (in addition to diet restrictions), in order to achieve remission. IOW, an asymptomatic food intolerance may not cause an apparent reaction, but the long-term damage that it causes, may allow the tiniest amounts of other symptomatic intolerances to trigger reactions, or possibly the damage might cause virtually all food to trigger an adverse reaction.
Looking back, my small intestine was a major source of irritation during reaction episodes, more so, I believe, than my colon, as far as gas and bloating was concerned.
Anyone else have any thoughts/comments on this?
Tex