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GI Infections May Lead to Microscopic Colitis

Gastrointestinal infections, such as Clostridioides difficile (C diff), may be linked to an elevated risk of microscopic colitis (MC) development, a nationwide study supported by the Regional Ethics Committee of Sweden revealed.

Researchers studied the links between MC and gastrointestinal infections, as they can alter the function and composition of the gut microbiome, triggering the development of inflammatory bowel disease.

“We conducted a case-control study of all adult patients with MC diagnosed between 1990 and 2016 in Sweden matched to up to 5 general population controls according to age, sex, calendar year, and county,” the authors reported. “Cases of MC were identified using Systematized Nomenclature of Medicine codes from the Epidemiology Strengthened by histoPathology Reports in Sweden (ESPRESSO) study—a cohort of gastrointestinal pathology reports from all 28 pathology centers in Sweden. We used logistic regression modeling to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).”

During the study, researchers found 13,468 cases of MC matched with 64,479 controls, revealing 7.5% of patients with MC were previously diagnosed with gastrointestinal infection—significantly higher than among controls.

“After adjustment, gastroenteritis was associated with an increased risk of MC (95% CI). Among specific pathogens, Clostridioides difficile, Norovirus, and Escherichia species (but not Salmonella species), were associated with an increased risk of MC. The association between gastrointestinal infections and risk of MC was stronger for collagenous subtype, as compared with lymphocytic colitis,” the authors concluded.  

 

--Angelique Platas

 

Reference:

 

Khalili H, Axelrad JE, Roelstraete B, Olén O, D’Amato M, Ludvigsson JF. Gastrointestinal infection and risk of microscopic colitis: a nationwide case-control study in Sweden. AGA 2021;160(5):1599-1607

doi: https://doi.org/10.1053/j.gastro.2021.01.004