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Monday Poster Session

Category: Colon

P2408 - Global Incidence and Risk Factors of Microscopic Colitis: A Systematic Review

Monday, October 27, 2025
10:30 AM - 4:00 PM MT
Location: Exhibit Hall
⁠Berjis Rahmath, MBBS1, Swetha Chinthala, 2, Pranay Marlecha, MBBS3, Dinesh Kumar Eetala, MBBS4, Laxmi Mahita Reddy Paripati, MBBS5, Nikhil Kumar Balagoni, MBBS1, Rithik Naik Korra, MBBS1, Heom Mahendra Bhatt, MBBS6, Dushyant S. Dahiya, MD7
1Osmania General Hospital and Medical College, Hyderabad, Telangana, India; 2Davao Medical School Foundation Inc, Davao, Davao del Sur, Philippines; 3Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India; 4MBBS, San Diego, CA; 5Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India; 6Dr.M.K.Shah medical College and Research centre, Bagasara, Gujarat, India; 7University of Kansas School of Medicine, Kansas City, KS

Introduction:

Microscopic colitis (MC) is a chronic inflammatory disease of the colon characterized by persistent non-bloody watery diarrhea which significantly impacts the patient’s quality of life. The global incidence of MC is poorly understood and reported, the accuracy of which is essential for public health planning and increasing physician awareness. We conducted a systematic review to summarize existing data on the global incidence rates of MC, explore its regional variations, and identify the strength and validity of pertaining risk factors.

Methods:

A comprehensive literature search of PUBMED was performed from inception to May 2025 to identify relevant MC studies. Studies with observational design, such as cross-sectional, case-control, population-based cohort, and registry-based studies using local or national health databases, with biopsy-confirmed MC were all eligible. Primary outcomes included the quantitative estimates of incidence rates and secondary outcomes included the quantitative estimates of associated risk factors. Case reports and case series that involved fewer than 10 patients were excluded.

Results:

A total of 20 studies on risk factors and 22 studies on rates of incident cases from Europe and North America were included in the final analysis. MC was reported to occur at rates between 4.8 and 25.8 out of every 100,000 person-years and in Sweden, Denmark, Switzerland, the United Kingdom, and the USA, with increasing incidence over the past two decades.

Several consistent patterns were found during the analysis of risk factors. Many studies found celiac disease to be the most common risk factor, with odds ratios (OR) between 7.9 and 22.5. The use of antibiotics, NSAIDs, and PPIs have been closely liked to MC and the ORs for NSAIDs and PPIs were as high as 20.2 and 10.6, respectively. Other risks such as psychiatric illnesses, smoking, C. difficile, Campylobacter, and Norovirus were also noted. According to the results from large registry studies, female gender and advanced age have also been linked to MC.

 

Discussion:

Our study highlights the fact that MC has become more common worldwide and relates to a combination of factors such as the immune, microbiome, environmental, and drug-related risks. These findings emphasize the need for heightened clinical awareness and prospective research to clarify causal pathways, optimize prevention strategies and inform evidence-based treatment approaches.

Disclosures:
⁠Berjis Rahmath indicated no relevant financial relationships.
Swetha Chinthala indicated no relevant financial relationships.
Pranay Marlecha indicated no relevant financial relationships.
Dinesh Kumar Eetala indicated no relevant financial relationships.
Laxmi Mahita Reddy Paripati indicated no relevant financial relationships.
Nikhil Kumar Balagoni indicated no relevant financial relationships.
Rithik Naik Korra indicated no relevant financial relationships.
Heom Mahendra Bhatt indicated no relevant financial relationships.
Dushyant Dahiya indicated no relevant financial relationships.

⁠Berjis Rahmath, MBBS1, Swetha Chinthala, 2, Pranay Marlecha, MBBS3, Dinesh Kumar Eetala, MBBS4, Laxmi Mahita Reddy Paripati, MBBS5, Nikhil Kumar Balagoni, MBBS1, Rithik Naik Korra, MBBS1, Heom Mahendra Bhatt, MBBS6, Dushyant S. Dahiya, MD7. P2408 - Global Incidence and Risk Factors of Microscopic Colitis: A Systematic Review, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.