Both microscopic colitis (MC) and ulcerative colitis (UC) can cause colon inflammation but may have slightly different symptoms. UC is visible during a colonoscopy, but MC often requires a biopsy.
While both microscopic colitis (MC) and ulcerative colitis (UC) are types of inflammatory bowel disease (IBD) and cause colon inflammation, the biggest difference between them is that you can typically only see MC under a microscope.
While MC and UC can both cause similar symptoms, there are also key differences, particularly around the presence of blood and mucus in the stool. Many of the conditions that fall under the heading of IBD have similar symptoms, so determining which someone has typically requires testing, including a colonoscopy.
Keep reading to learn more about the differences between these two types of colitis and how doctors diagnose and treat them.
Both UC and MC are types of IBD and cause inflammation, but they are not the same thing.
UC causes inflammation and ulcers to develop in the inner lining of the colon. Doctors can see these lesions during a colonoscopy.
However, with MC, doctors can only see changes to the large intestine tissue under a microscope. Diagnosing it requires removing a small section of colon tissue during a colonoscopy. This is known as a biopsy. Doctors further classify MC as collagenous colitis or lymphocytic colitis, depending on specific changes in the tissue.
Depending on which condition you’re living with, you may experience some of the same or different symptoms.
| Symptoms | Microscopic colitis (MC) | Ulcerative colitis (UC) |
|---|---|---|
| Abdominal pain | x | x |
| Diarrhea | x | x |
| Blood or mucus in stool | x | |
| Bathroom urgency | x | x |
| Fatigue | x | x |
| Weight loss | x | x |
| Incontinence | x | |
| Dehydration | x | |
| Fever | x | |
| Joint swelling/pain | x | |
| Mouth sores | x | |
| Nausea | x | |
| Decreased appetite | x |
Both UC and MC cause diarrhea, but UC
Symptoms of both MC and UC can vary in intensity from person to person and 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.
MC is unlikely to turn into UC.
While 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 originally misdiagnosed as MC.
Does having microscopic colitis increase your risk of colon cancer?
Research does not suggest a link between MC and colon cancer.
However, having UC increases the risk of developing colon cancer. At least
The diagnosis of MC or UC typically involves your doctor taking a thorough medical history and performing a physical exam.
If your doctor suspects UC or MC, they often request that you have a colonoscopy, as doctors can see evidence of UC during the exam.
But if you have MC, doctors may not see anything with the naked eye. If they suspect MC, a doctor will take a tissue sample during the colonoscopy to have 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. Doctors often suggest medications and dietary adjustments at first. But for severe symptoms, they may recommend surgery.
Some medications you might be taking may contribute to MC or UC flares. Your care team will likely review your medication history and change certain medications if this is the case.
The doctor may also prescribe various medications to decrease inflammation and relieve symptoms of MC and UC. These can include:
- corticosteroids
- antidiarrheal medications
- biologics
Your doctor may also suggest dietary changes to reduce inflammation if you have MC or UC.
Food choices for both conditions
Learn more about MC dietary considerations and UC dietary considerations.
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 smoking as soon as possible. They may also suggest reducing your alcohol intake or trying to get 8 hours of sleep a night.
Can microscopic colitis just go away?
In some people, symptoms of MC can go away without treatment.
Others may need to take bulk-forming agents such as psyllium, antidiarrheal medications, or the corticosteroid budesonide (Entocort) to relieve their symptoms.
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 also tends to include blood or rectal bleeding. Doctors are also often able to see it during a colonoscopy, while MC generally requires a biopsy to diagnose.
If you’re experiencing abdominal pain and issues with your stools, talk with a doctor so they can determine the exact cause and develop a treatment plan to reduce your symptoms.