Are you also tired of having watery bowel movements? Having bowel movements like this several times a day is really annoying, isn't it? Sometimes the reason for this may not be as simple as we think. That is one such condition called `(Lymphocytic Colitis)`. Let's talk about this in a little more detail today.
What is this `(Lymphocytic Colitis)`? Let's understand exactly!
Simply put, `(Lymphocytic Colitis)` is an inflammation that occurs in the large intestine (colon) . But this is not a normal inflammation. This belongs to a type of disease called `(Microscopic Colitis).` That is, this inflammation is so small that our naked eye cannot see it. It can only be identified accurately if you look at it with a microscope .
Now, doctors identify the different types of `(Microscopic Colitis)` by analyzing the types of cells in the lining of our intestines. In `(Lymphocytic Colitis)`, what happens is that a type of white blood cell called `(Lymphocytes)` in the lining of our intestines increases in number much more than normal. These `(Lymphocytes)` cells usually increase when our immune system is fighting an infection. So, in `(Lymphocytic Colitis)`, what happens is that our body behaves as if there is an infection, even though there is actually no infection . Does this sound a bit complicated?
So is `(Lymphocytic Colitis)` an `(Autoimmune Disease)`?
Many scientists think so . In fact, many of the diseases that fall into the category of `(Inflammatory Bowel Diseases)` (IBD) are considered to be `(Autoimmune)` conditions. In an `(Autoimmune Disease)`, what happens is that our own immune system attacks our own cells . It's as if our own cells are mistaken for something foreign, harmful. These conditions can be caused by both genetic and environmental factors .
How serious is Lymphocytic Colitis?
Lymphocytic Colitis causes long-term inflammation of your colon. The colon is the last part of your digestive system (Gastrointestinal tract). This is where the food we eat gradually solidifies and forms into poop. So, when the colon becomes inflamed, this process can be disrupted. The most common result of Lymphocytic Colitis is chronic, watery diarrhea, which can occur five to ten times a day .
Imagine how much this frequent, sudden bowel movement can affect your quality of life . But the good news is that most people only experience these symptoms occasionally. Although lymphocytic colitis is a lifelong condition, there can be long periods of remission . Even if symptoms do occur, most people can manage it with medication and diet. It is less likely to cause serious, permanent damage to the colon than other types of inflammatory bowel disease.
Who is most affected by this condition (Lymphocytic Colitis)?
Although it can develop in anyone, it becomes more common with age . It is very rare in children. It is most often diagnosed after the age of 65. Women are twice as likely to develop it as men . It is also more common in people who smoke tobacco . It is also said that they can develop `(Lymphocytic Colitis)` on average about 10 years earlier than others.
Surprisingly, about 40% of people with Lymphocytic Colitis have another autoimmune disease. For example:
- Rheumatoid Arthritis
- Celiac Disease
- Type 1 Diabetes
- Thyroid Disease
What are the symptoms of `(Lymphocytic Colitis)`?
Lymphocytic Colitis changes the cellular composition of the lining of your colon (the mucosa). This causes you to have watery bowel movements five to ten times a day . About half of patients also report abdominal cramping and pain. In severe cases, you may experience side effects such as fecal incontinence , dehydration , unintended weight loss , or fatigue .
Some people may also experience symptoms related to inflammation in other parts of the body. This is common with long-term inflammatory diseases. In fact, it is common for people with `(Lymphocytic Colitis)` to have more than one `(Autoimmune Disease)` at the same time. Common additional symptoms include joint pain and stiffness (`(Arthritis)`) , inflammation of the eyes (`(Uveitis)`) , and skin lesions (`(Psoriasis)`) .
What are the causes of Lymphocytic Colitis?
Chronic inflammation in your colon causes cellular changes that keep your colon from leaking. However, scientists are still not entirely sure why this chronic inflammation occurs without an actual infection. Many people think that it is caused by a combination of factors . Some people may be genetically predisposed to developing this type of autoimmune disease. However, in addition, some environmental stress factor may trigger it.
Things that can be 'triggers' like this are:
- A previous bacterial or viral infection in your gut.
- Food or pollen allergies that affect your gut.
- Frequent use of certain medications such as `(Aspirin)` and `(Ibuprofen)`.
- Smoking .
How is Lymphocytic Colitis diagnosed?
As the name suggests, lymphocytic colitis can only be diagnosed with a tissue sample that is examined under a microscope . This tissue sample is taken by a gastroenterologist during a colonoscopy. During this procedure, the doctor uses a flexible instrument (colonoscope) to examine the inside of your colon. Through the instrument , several tissue samples (biopsies) are taken and sent to a laboratory for analysis.
Important: If you have `(Lymphocytic Colitis)`, your colon may look normal at first glance during `(Colonoscopy)`. However, `(Biopsy)` samples will reveal inflammation with an excess of `(Lymphocytes)` cells.
If there is another condition, it may be seen during a colonoscopy. Your doctor will try to rule out other possible causes before testing for microscopic colitis. They may also do blood tests or poop tests first.
How is Lymphocytic Colitis treated?
Some people get better with simple treatments, while others need prescription medication. It may take some trial and error to determine what works best for you. Your doctor will make recommendations based on the severity of your symptoms and how you respond to conventional treatments. Before prescribing a new medication, they may first suggest changes to your current medications and diet.
Medications may include:
- Over-the-counter (OTC) antidiarrheal drugs - for example, Loperamide or Diphenoxylate.
- Bismuth Subsalicylate (Pepto Bismol®) several times a day for several weeks.
- `(Budesonide)` - This is a type of `(Corticosteroid)` that reduces inflammation and is absorbed in the large intestine.
- Bile acid sequestrants - Examples: Colesevelam, Colestipol. These can treat some types of stomach ulcers.
Can Lymphocytic Colitis be completely cured?
Strictly speaking, it cannot be cured completely , as it can recur. However, it is possible to go into remission . This means that the bowel movements and inflammation disappear. Many people see their symptoms disappear completely within a few years. For some people, this 'remission' occurs spontaneously. For others, it occurs after finding the right treatment, diet and lifestyle changes for them.
What is the best diet for someone with Lymphocytic Colitis?
Your doctor may recommend that you avoid foods that increase flatulence. If you're interested, you can try these foods one by one to see if they affect you. There may be foods that are not on this list that you are allergic to that are unique to you. Pay attention to how your symptoms change when you eat and avoid certain foods . (An elimination diet, such as the Low-FODMAP diet, can help you identify foods that are causing your symptoms.)
Common foods to avoid are:
- Alcohol
- Caffeine (like tea, coffee)
- Artificial sweeteners
- Dairy products
- Gluten (a protein found in things like wheat and barley)
- High-fiber foods
- High-fat foods
When your diarrhea is at its worst, your doctor may tell you to go on the `(BRAT diet)` . `(BRAT)` stands for `(Bananas, Rice, Apple sauce, Toast)` - that is , bananas, rice, applesauce (a sauce made from boiled apples) and bread . Simply put, bland, easily digestible foods. This is not a long-term diet, but it is good for a few days. If you need a more varied, but bland diet to control your symptoms for a longer period of time, try a `(soft diet)` . It is low in fat and fiber, but high in variety and nutrition.
What is the difference between `(Lymphocytic Colitis)` and `(Collagenous Colitis)`?
Collagenous Colitis is the other major type of Microscopic Colitis. Collagenous Colitis is characterized by an abnormal thickening of the connective tissue lining the colon. Apart from these microscopic changes, both Collagenous Colitis and Lymphocytic Colitis have similar symptoms and are treated in the same way . Some believe that these two may actually be different stages of the same disease.
Lymphocytic Colitis is a relatively sudden, long-term disease that usually appears late in life. It's also a bit of a mystery and not as well understood as other inflammatory bowel diseases. So, if you've never heard of it before, it can be a bit confusing to be diagnosed with it. But the good news is that it's usually a manageable disease . With treatment and self-care, it can even go into remission.
Take-Home Message
Okay, so I hope you now have a better understanding of what we talked about today. Remember:
- This is an inflammation of the large intestine that can only be seen under a microscope.
- The main symptom is watery bowel movements several times a day.
- This could be an ``Autoimmune'' condition.
- It is more common with age, especially in women and smokers.
- To diagnose the disease, you need to do a ``Colonoscopy`` and take a ``Biopsy``.
- This can be controlled with medication, diet, and lifestyle changes.
- Although it cannot be completely cured, it is possible to enter a state of 'remission' where symptoms disappear.
If you have these symptoms, don't hesitate to see a doctor for advice. The sooner it's detected, the easier it is to control.
` Lymphocytic colitis, bowel obstruction, colitis, microscopic colitis, autoimmune diseases, digestive system, colonoscopy
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