Article information
Resumen
La diarrea es un problema clínico frecuente que puede ser expresión de enfermedades sistémicas, intestinales o bien estar en relación con formas de colitis de descripción relativamente reciente que pueden plantear dificultades de diagnóstico diferencial, por lo que se debe estar preparado para reconocerlas. En este sentido, la colitis microscópica es una causa no excesivamente infrecuente de diarrea crónica en el paciente geriátrico con colonoscopia normal y que requiere biopsias colónicas para llegar al diagnóstico. Esta entidad tiene dos subtipos, colitis colágena y linfocítica, según la presencia o ausencia de una banda colágena subepitelial engrosada, y que posiblemente correspondan a variantes de la misma enfermedad, con una clínica similar en ambas. Aunque un escaso porcentaje de pacientes presenta remisión espontánea, la evolución es por lo habitual intermitente y destaca que, a pesar del escaso número de ensayos terapéuticos controlados, dispone de un tratamiento eficaz para el control sintomático.
Palabras clave:
Diarrea
Colitis microscópica
Paciente geriátrico
Tratamiento
Curso evolutivo
Abstract
Diarrhoea is a frequent clinical problem that may be a symptom of systemic or intestinal disease but it can also be related to forms of colitis that have only recently been described. These forms create difficulties in differential diagnosis and clinicians should be able to recognise them. In this context, microscopic colitis is a not infrequent cause of chronic diarrhoea in geriatric patients who show normal colonoscopy and who require colonic biopsy to establish the diagnosis. This entity has two subtypes, collagenous and lymphocytic colitis, depending on the presence or absence of a thickened subepithelial collagenous band. These two subtypes are possibly variants of the same disease and provoke similar symptoms.Although some patients present spontaneous remission, the clinical course is usually intermittent. Few controlled therapeutic trials are available but effective treatment for symptomatic control is available.
Key words:
Diarrhoea
Microscopic colitis
Geriatric patient
Treatment
Clinical course
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