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The differential diagnosis of unexplained chronic or intermittent diarrhea in a patient with a normally appearing colon includes microscopic colitis (i.e., collagenous or lymphocytic colitis) and functional bowel disorders. Researchers in France conducted this prospective study to identify clinical factors that might distinguish between these entities.
The cohort included 433 adults with at least three bowel movements daily (with change in consistency) for at least 4 weeks and normal or near-normal macroscopic appearance of the colon at colonoscopy. All patients had colon biopsies at multiple sites to establish or exclude microscopic colitis, as well as evaluations to exclude other causes of diarrhea.
Microscopic colitis was diagnosed in 30% …