RESUMO
INTRODUCTION: Primary eosinophilic colitis (PEC) is an inflammatory disease caused by the infiltration of eosinophils into the mucosa of the colon, determined after having ruled out other possible causes. It is characterized by abdominal pain and diarrhea and its prevalence is unknown. AIMS: To know the prevalence of PEC in patients with chronic diarrhea and in those with clinical criteria for diarrhea-predominant irritable bowel syndrome (IBS-D). PATIENTS AND METHODS: All patients with chronic noninflammatory diarrhea that were consecutively seen over a decade were studied through colonoscopy, with systematic biopsy. Patients with a known or decompensated organic disease, alarm features, abnormal minimal laboratory test results, and factors associated with eosinophilia were excluded. Patients with the clinical criteria for IBS-D (Rome III) were selected from the general group. Eosinophilic colitis was defined as the presence of > 35 eosinophils/100 epithelial cells per field in any of the segments. RESULTS: From the 683 patients seen, a total of 545 patients (361 women) were included in the study. Twenty-two cases of PEC were detected, resulting in a prevalence of 4.0%. A total of 343 patients had IBS-D criteria (223 women), with 16 cases of PEC detected, for a prevalence of 4.7%. Colonoscopy was normal, or almost normal, in all the PEC cases detected. CONCLUSIONS: The prevalence of PEC was 4.0% in the patients with chronic diarrhea and 4.7% in the patients with IBS-D. Peripheral eosinophilia appeared to be the main distinctive clinical characteristic, but systematic biopsy was essential for making the diagnosis.
Assuntos
Colite Microscópica , Eosinofilia , Síndrome do Intestino Irritável , Colite Microscópica/complicações , Colite Microscópica/diagnóstico , Colite Microscópica/epidemiologia , Diarreia/diagnóstico , Diarreia/epidemiologia , Diarreia/etiologia , Enterite , Eosinofilia/complicações , Eosinofilia/epidemiologia , Feminino , Gastrite , Humanos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/epidemiologia , PrevalênciaRESUMO
INTRODUCTION: The microscopic colitis (MC) is characterized by the presence of aqueous chronic diarrhea (ACD) with inflammatory elements in the colon only detectable by microscopy. OBJECTIVES: To know the prevalence of MC in the group of patients with ACD attending the Endoscopy Service of the British Hospital from Montevideo. MATERIAL AND METHODS: We retrospectively included patients with ACD who were studied by endoscopy during a period of 5 years and the endoscopy was normal or showed minimal alterations. Biopsies in different parts of the colon were taken to this group of patients aiming to diagnose this entity. RESULTS: We included 180 patients, 101 women (56%) and 79 men (44%). No lesion was found in the endoscopy in 67% of them, 27% had a diverticular colopathy and 5% a non-specific colitis. Out of the total number of patients, 9% had a histological study compatible with MC, 82% had lymphocytic colitis (CL) and 18% collagenous colitis (CC), with a ratio between men and women of 1.8:1 and 1:2, respectively. The mean age for the diagnosis was 43 years old in the group of CL and 61 years old in the group of CC. Endoscopic lesions were not found in 94% of patients with MC and only 1 patient presented a non-specific colitis at the endoscopy. The 65% of the remaining patients did not show histological alterations and 26% of them presented non-specific inflammatory changes. CONCLUSIONS: The prevalence of MC in our series was similar to that found in other publications and alterations in the colonic mucosa were not found in most cases. The CL was the most frequent form of presentation and was found at an earlier age than the CC. The CL was more frequent in men. Knowing that the CM is a rare illness in our environment, these findings suggest the importance of taking multiple biopsies from different parts of the colon when patients with ACD are studied.