Agustos 2022
Mikroskopik kolit ve diyare baskin irritabl barsak sendromu tanisi almis hastalarin klinik ve laboratuvar olarak karsilastirilmasi
Comparison of clinical and laboratory findings of patients diagnosed with microscopic colitis and diarrheapredominant irritable bowel syndrome
- Ana Sayfa
- Sayılar
- Agustos 2022
- Mikroskopik kolit ve diyare baskin irritabl barsak sendromu tanisi almis hastalarin klinik ve laboratuvar olarak karsilastirilmasi...
Istanbul Yeni Yüzyil Üniversitesi, Tip Fakültesi, Özel Gaziosmanpasa Hastanesi, 2Patoloji Klinigi, Istanbul
Özet
Giris ve Amaç: Mikroskopik kolit ve diyare baskin irritabl barsak sendromlu hastalarda basta sulu diyare ve karin agrisi olmak üzere benzer semptomlar görülür. Mikroskopik kolitin toplumda sikligi göreceli olarak azdir ve kesin tani kolonoskopik incelemeyle alinan biyopsilerin histopatolojikdegerlendirilmesi ile konur. Muhtemelen bir kisim mikroskopik kolit hastasi kolonoskopi yapilmadigi ve semptom örtüsmeleri nedeniyle diyare baskinirritabl barsak sendromu tanisi ile takip edilmektedir. Bu çalismada histopatolojik olarak mikroskopik kolit ve diyare baskin irritabl barsak sendromutanisi almis hastalarimizi klinik ve laboratuvar olarak karsilastirmayi ve iki grup arasinda benzer ve ayrisan yönleri arastirmayi amaçladik. Gereç veYöntem: Çalismamiza Eylül 2016 ile Subat 2022 tarihleri arasinda gastroenteroloji klinigimizde takip edilen 41 mikroskopik kolit ve 41 diyare baskinirritabl barsak sendromlu hasta dahil edildi. Her iki grup hastaya da kolonoskopik inceleme yapilmis, biyopsiler alinmis ve histopatolojik degerlendirmeyapilmisti. Bu iki grubun klinik, laboratuvar, kolonoskopik ve histopatolojik verileri retrospektif olarak incelenerek karsilastirildi. Bulgular: Çalismayaalinan her iki grup hastanin demografik verileri benzerdi (yas ortalamalari; mikroskopik kolit: 50.96 yil, diyare baskin irritabl barsak sendromu: 51.45yil, kadin/erkek oranlari her iki grup için: 1.56). Merkezimizin mikroskopik kolit prevalansi her 100 hastada 1.67 idi. Mikroskopik kolit hastalarinin%41.46’si diyare baskin irritabl barsak sendromu için Roma IV kriterlerini karsilamaktaydi. Mikroskopik kolit hastalarinda; kronik ishal %78.05, kilokaybi %19.51, B12 vitamini eksikligi %12.20, çölyak hastaligi birlikteligi %4.88, karin agrisi %41.46 oraninda izlenirken, bu oranlar diyare baskin irritablbarsak sendromlu hastalarda sirasi ile %43.90, %9.76, %0.00 ve %78.05 olarak saptandi. Sonuç: Mikroskopik kolit hastaligi toplumda sanildigindandaha sik görülmektedir. Ancak birçok mikroskopik kolit hastasinin semptomlarin benzerligi nedeniyle diyare baskin irritabl barsak sendromu tanisi iletakip edildigi düsünülmektedir. Çalismamizda kronik sulu diyare, kilo kaybi, B12 vitamin eksikligi ve çölyak hastaligi birlikteliginin mikroskopik kolithastalarimizda; karin agrisinin ise diyare baskin irritabl barsak sendromu hastalarimizda daha sik oldugunu saptadik. Bu sayilan semptom ve bulgularla karsilasildiginda mikroskopik kolit tanisi akla gelmelidir ve bu hastalara kolonoskopik inceleme yapilmalidir.
Abstract
Background and Aims: Patients with microscopic colitis and diarrhea-predominant irritable bowel syndrome have similar symptoms, primarilywatery diarrhea and abdominal pain are observed in patients with microscopic colitis and diarrhea-predominant irritable bowel syndrome. Probably some microscopic colitis patients are followed up with the diagnosis of diarrhea-predominant irritable bowel syndrome because colonoscopy isnot performed and symptoms overlap. In this study, we aimed to compare our patients with histopathological diagnosis of microscopic colitis anddiarrhea-predominant irritable bowel syndrome patients clinically and laboratoryly, and to investigate the similarities and differences between thetwo groups. Materials and Methods: 41 microscopic colitis and 41 diarrhea-predominant irritable bowel syndrome patients followed up in ourgastroenterology clinic between september 2016 and february 2022 were included in our study. Colonoscopy was performed, biopsies were taken,and histopathological examination was performed in both groups of patients. The clinical, laboratory, colonoscopic and histopathological data ofthese two groups were analyzed retrospectively and compared. Results: Demographic data of both groups of patients included in the study weresimilar (mean age: microscopic colitis: 50.96 years, diarrhea-predominant irritable bowel syndrome: 51.45 years, female/male ratios for both groups:1.56). The prevalence of microscopic colitis in our center was 1.67 per 100 patients. 41.46% of microscopic colitis patients met the Rome IV criteriafor diarrhea-predominant irritable bowel syndrome. While chronic diarrhea prevalance was 78,05%, weight loss: 19.51%, vitamin B12 deficiency:12.20%, coexistence with Celiac disease: 4.88%, abdominal pain: 41.46% in microscopic colitis patients; these rates were found to be 43,90%, 9.76%,0.00% and 78.05%, respectively in diarrhea-predominant irritable bowel syndrome patients. Conclusion: microscopic colitis is encountered morefrequently than it is thought, in the population. Many microscopic colitis patients are followed up with the diagnosis of diarrhea-predominant irritablebowel syndrome due to the similarity of symptoms. In our study, we determined that the association of chronic watery diarrhea, weight loss, vitaminB12 deficiency and Celiac disease was more common in patients with microscopic colitis whereas abdominal pain was more common in patients withdiarrhea-predominant irritable bowel syndrome. When these symptoms and signs are encountered in patients, the diagnosis of microscopic colitisshould be considered and colonoscopic examination should be performed.
