Introduction
Microscopic colitis (MC) is a chronic inflammatory disease of the large bowel characterized by watery diarrhea, stool leakage, and nightly defecation, leading to impaired quality of life. Scarce consistent data suggest the association of MC with certain risk factors.
Aims & Methods
We aimed to assess MC’s lifestyle and medical risk factors.
Our protocol was prospectively registered with PROSPERO (CRD42022286624). We systematically searched three medical databases from inception to the 18th of December 2021 (Pubmed, Embase, and Cochrane). Cohort, case-control, and cross-sectional studies, reporting on the number of risk factors in MC patients compared to controls with or without a histopathological examination, were included. We used the random-effect model to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). The risk of bias assessment was made with the aid of the QUIPS tool.
Results
The systematic search yielded 7174 articles, and 43 were eligible for the study. Investigating lifestyle factors, current smoking was associated with a 1.64 odd (CI:1.06–2.52), while past smoking had a 1.28 odd (CI: 0.91–1.81) of MC compared to both types of controls. Regarding alcohol consumption, we could only do a comparison to controls who were not examined histologically, and no significant association with MC was found. Similarly, we could not show a significant association between MC and patients’ level of education.
When investigating medical risk factors, we found a twofold increased chance of MC diagnosis in the case of non-steroidal anti-inflammatory drug (NSAID) use (OR =2.07, CI: 1.31–3.27), but the odds of MC were not significantly increased neither in the case of proton pump inhibitors (OR =1.59, CI: 0.65–3.90) nor in the case of selective serotonin reuptake inhibitors (OR =2.10, CI: 0.73–5.98), compared to the overall control group.
Most of the articles were deemed moderate or high risk of bias due to the low number of patients and the lack of confounding factors assessment.
Conclusion
Our data demonstrate a 64% increase in the odds of MC in the case of current smoking, and NSAID use is associated with a twofold risk for MC. Further prospective studies with longer follow-ups are needed to further investigate these associations.
Disclosure
None to declare