One other thing I wanted to discuss was my diagnosis. Last September, my biopsies showed both thickened collagen and increased lymphocytes. My GI called it "Non-specific Microscopic Colitis." I have read that there is a theory that both collagenous and lymphocytic colitis are actually different stages of the same disease. Does everyone here know exactly which type they have? What does everyone think about this theory?
Leanne
My Diagnosis
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Leanne,
It's a moot point, because research shows that the disease can segue back and forth between the 2 phases. Besides, the clinical symptoms and the treatment are the same. That makes the diagnostic criteria pretty much of academic interest only. There are at least a dozen different forms of MC. All of them have unique diagnostic criteria, but they all have similar symptoms and treatment (except that mastocytic enterocolitis requires some additional considerations). Most GI docs have only heard of the 3 most common forms (some are only familiar with 2).
It is thought that CC is a later stage of the disease, mostly because it takes a while for the collagen layers to thicken, but not everyone progresses to that stage, so it can hardly be considered to be a true stage of the disease. And some cases convert back to LC.
Almost all cases of CC also involve the same type of lymphocytic infiltration that is diagnostic of LC. In some cases, the lymphocyte count is high enough to qualify for a diagnosis of LC, while in others the count is elevated, but still below the technical threshold for a diagnosis of LC. When both markers are present (which is usually the case) some doctors refer to this as "CC" (ignoring the lymphocytes, since their presence is irrelevant to a diagnosis of CC), and some simply refer to the condition as "MC".
IOW, if collagen band thickening is sufficient for a diagnosis of CC, then the diagnosis is either CC or MC. Otherwise the diagnosis is LC (assuming that the lymphocyte count is higher than 20 lymphocytes per 100 enterocytes). But all of this is irrelevant when it comes to treating the disease.
At least that's how I see it.
Tex
It's a moot point, because research shows that the disease can segue back and forth between the 2 phases. Besides, the clinical symptoms and the treatment are the same. That makes the diagnostic criteria pretty much of academic interest only. There are at least a dozen different forms of MC. All of them have unique diagnostic criteria, but they all have similar symptoms and treatment (except that mastocytic enterocolitis requires some additional considerations). Most GI docs have only heard of the 3 most common forms (some are only familiar with 2).
It is thought that CC is a later stage of the disease, mostly because it takes a while for the collagen layers to thicken, but not everyone progresses to that stage, so it can hardly be considered to be a true stage of the disease. And some cases convert back to LC.
Almost all cases of CC also involve the same type of lymphocytic infiltration that is diagnostic of LC. In some cases, the lymphocyte count is high enough to qualify for a diagnosis of LC, while in others the count is elevated, but still below the technical threshold for a diagnosis of LC. When both markers are present (which is usually the case) some doctors refer to this as "CC" (ignoring the lymphocytes, since their presence is irrelevant to a diagnosis of CC), and some simply refer to the condition as "MC".
IOW, if collagen band thickening is sufficient for a diagnosis of CC, then the diagnosis is either CC or MC. Otherwise the diagnosis is LC (assuming that the lymphocyte count is higher than 20 lymphocytes per 100 enterocytes). But all of this is irrelevant when it comes to treating the disease.
At least that's how I see it.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Leanne,
The connection between these issues could use a lot of medical research, but yes, there appears to be a connection, since the Epstein-Barr virus is so prevalent and it leads to complicating issues. There's a lot of speculation about the connection, and a number of research articles are cited in this old thread from a few years ago, if you are interested in this topic:
EPSTEIN-BARR VIRUS in MC and AUTOIMMUNITY!!
Tex
The connection between these issues could use a lot of medical research, but yes, there appears to be a connection, since the Epstein-Barr virus is so prevalent and it leads to complicating issues. There's a lot of speculation about the connection, and a number of research articles are cited in this old thread from a few years ago, if you are interested in this topic:
EPSTEIN-BARR VIRUS in MC and AUTOIMMUNITY!!
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.