How is microscopic colitis diagnosed?

Microscopic colitis is usually diagnosed by a gastroenterologist (a specialist in diseases of the digestive system). The gastroenterologist will perform a physical examination and will ask you about your symptoms and any medications you are taking.

The doctor may also order certain tests, including:

  • Blood tests
  • Lab tests
  • Stool tests
  • Imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI) and upper GI (the patient has an X-ray after drinking a barium solution, which causes the organs to show up more sharply) of the colon

The test that is most often used to make a definitive diagnosis of microscopic colitis is a colonoscopy with a biopsy. During a colonoscopy, the doctor uses a colonoscope (a long, flexible instrument about 1/2 inch in diameter) to view the lining of the colon. The colonoscope is inserted into the rectum and advanced through the large intestine. If necessary, small amounts of tissue can be removed for analysis (a biopsy) and polyps can be identified and entirely removed.

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