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Microscopic Colitis?


LisaaaNoel

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LisaaaNoel Explorer

First let me say that I haven't been diagnosed officially when celiac. I just began a gluten-free trial less than a week ago. I was diagnosed with IBS about a year ago.

From my understanding, one of the classic symptoms of microscopic colitis is watery diarrhea, correct? I have experienced a pattern like this the past month or so:

-woke up with watery D a week before thanksgiving. I went to the bathroom a few times throughout the day (went once in the middle of the night) I took immodium and it seemed to clear it up.

-about a week later, woke up again with watery d. same pattern. took immodium and it took a couple of days to clear up completely.

-This time, 2 weeks later, I woke up with watery D. Went about 3 times. Cleared up with imodium and this time didn't go at all during the night.

The idea of the watery D makes me think it could be MC, but the pattern does not necessarily seem like MC.

If you have it, could you weigh in on this? Possibly tell me about your symptoms/patterns? What about treatment? What should I expect if I did have this?

I feel completely fine, otherwise. I'm worried though, because I know you must get a biopsie to be diagnosed. I do not have insurance so that would be difficult.


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ravenwoodglass Mentor

Whether this is a symptom of MC I don't know but I do know that for me it was a symptom of celiac. I was diagnosed with IBS years ago and it wasn't until after I was diagnosed celiac and remarked to my GI that I was so thankful to be done with the middle of the night D that he told me that IBS doesn't wake someone up from sleep. Unfortunately he never listened when I told him about it prediagnosis. He just looked at negative celiac blood tests and prescribed more pills. Have you had a colonoscopy or endo? I think it is the colonoscopy that would diagnose MC but they do need to take biopsies to examine if it is suspected. Like celiac it is not always noticeable with the naked eye.

Also since the watery D started abruptly do make sure they do stool tests to make sure you haven't picked up food poisoning or such. I had salmonella once and had to beg for 2 weeks for testing. I kept telling my GP that what I was experiencing wasn't anything like the IBS that I was diagnosed with but she wouldn't listen until I had lost over 20 lbs, almost a fifth of my weight over a two week period, that she finally tested and found me postive for salmonella.

Ahorsesoul Enthusiast

Are you taking any medication before bed not on a regular schedule or are you eating/drinking something at night that is causing this diarrhea to start during the night?

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    • par18
      Thanks for the reply. 
    • Scott Adams
      What you’re describing is actually very common, and unfortunately the timing of the biopsy likely explains the confusion. Yes, it is absolutely possible for the small intestine to heal enough in three months on a strict gluten-free diet to produce a normal or near-normal biopsy, especially when damage was mild to begin with. In contrast, celiac antibodies can stay elevated for many months or even years after gluten removal, so persistently high antibody levels alongside the celiac genes and clear nutrient deficiencies strongly point to celiac disease, even if you don’t feel symptoms. Many people with celiac are asymptomatic but still develop iron and vitamin deficiencies and silent intestinal damage. The lack of immediate symptoms makes it harder emotionally, but it doesn’t mean gluten isn’t harming you. Most specialists would consider this a case of celiac disease with a false-negative biopsy due to early healing rather than “something else,” and staying consistently gluten-free is what protects you long-term—even when your body doesn’t protest right away.
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      Yes, I meant if you had celiac disease but went gluten-free before screening, your results would end up false-negative. As @trents mentioned, this can also happen when a total IGA test isn't done.
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