Both microscopic colitis (MC) and ulcerative colitis (UC) can cause colon inflammation. But UC inflammation can be seen during a colonoscopy and may present blood in your stool, while MC is typically only seen under a microscope.

It’s estimated that 3.1 million Americans live with inflammatory bowel disease (IBD) (IBD), which includes Crohn’s disease, ulcerative colitis (UC), and microscopic colitis (MC). Many of the conditions that fall under the heading of IBD have similar symptoms, so determining which someone has is not always easy.

While both MC and UC cause colon inflammation, the biggest difference between these two conditions is that MC is typically only able to be seen under a microscope. There are some other more subtle differences in the symptoms like the presence of blood and mucus in stools though.

While both MC and UC are considered types of IBD, microscopic colitis is not related to ulcerative colitis (or Crohn’s disease).

Approximately 9 to 20 new cases of UC per 100,000 people occur yearly. It can be further classified by the specific portions of the colon and rectum impacted.

On the other hand, one recent worldwide analysis showed results of 4.9 cases of collagenous colitis per 100,000 people and 5 cases of lymphocytic colitis per 100,000.

There are two different types of MC describing the changes in the tissue that are evident when viewed under a microscope called collagenous colitis and lymphocytic colitis.

Depending on which condition you’re living with, you may experience some of the same or different symptoms.

SymptomsMicroscopic colitis (MC)Ulcerative Colitis (UC)
Abdominal painxx
Bloody stoolx
Bathroom urgencyxx
Weight lossxx
Joint swelling/painx
Mouth soresx
Decreased appetitex

Symptoms of both MC and UC can vary in intensity from person to person. They can also change over time.

People may go through remission where they do not experience any symptoms, only to have old (or new) symptoms flare up again in the future.

There’s no current research proving MC turns into UC.

But a few cases have been reported. The number is so low it could be a chance association. There’s also a chance that the UC was just originally misdiagnosed as MC.

One way that MC and UC differ is that UC does have a risk for developing into colon cancer. At least 5% of people with UC develop colon cancer, and the risk increases the longer one has the disease. MC does not carry this same risk.

Diagnosis for MC or UC will typically first involve your doctor taking a thorough medical history and performing a physical exam.

If your doctor suspects UC or MC, they may request that you have a colonoscopy performed. Evidence of UC will often be visible during this.

But they may not see anything even if you have MC. If MC is suspected, they’ll take a tissue sample during the colonoscopy and have it analyzed.

Your doctor may also do a stool or blood test to help diagnose UC.

Treatment for both MC and UC varies depending on the severity of the symptoms and the frequency of the flares. In severe cases, surgery may be required, but typically doctors first suggest medications and dietary adjustments.

In addition to changing any medications that may be causing MC or UC flares, your doctor may prescribe a variety of medications to decrease the inflammation and symptoms of MC and UC. These can include:

Your doctor may also suggest dietary changes to reduce inflammation if you MC and UC.

Food choices for both conditions

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Lifestyle changes may also be helpful in reducing MC and UC pain. For example, if you have MC and smoke, your doctor will likely advise that you stop doing so as soon as possible. They may also ask you to reduce your alcohol intake or try to get 8 hours of sleep a night.

MC and UC are unrelated forms of IBD, but they have many overlapping symptoms.

While you may experience abdominal pain and frequent stools with both conditions, UC may also include blood or rectal bleeding. It’s also frequently able to be visually detected during a colonoscopy, while MC generally requires a microscope.

If you’re experiencing abdominal pain and issues with your stools, talk with a doctor so they can determine the exact cause and a treatment plan to reduce the symptoms you experience.