Lymphocytic colitis is a type of microscopic colitis that causes persistent, watery diarrhea. Experts still do not know the exact underlying cause.

Microscopic colitis involves inflammation of the colon. There are two types: lymphocytic and collagenous. Lymphocytic colitis causes chronic, watery diarrhea that does not contain blood.

Healthcare professionals determine the type of colitis a person has through microscopic evaluation of biopsies taken during a colonoscopy procedure.

This article describes lymphocytic colitis, including its symptoms, causes, risk factors, and more.

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Lymphocytic colitis is a type of microscopic colitis. Diagnosis involves taking a biopsy and checking for inflammation under a microscope.

This form of colitis causes watery, chronic diarrhea that is not bloody.

Lymphocytic colitis is a form of inflammatory bowel disease (IBD) unrelated to ulcerative colitis or Crohn’s disease. It does not increase a person’s risk of colon cancer.

According to a 2022 article, lymphocytic colitis affects about 2.3 to 16 per 100,000 people. The article also states that most people with microscopic colitis receive a diagnosis around age 65 or older, while around 25% are under 45.

A person with lymphocytic colitis typically has abdominal pain and chronic watery diarrhea, which doctors define as lasting at least 4 weeks.

Up to 22% of people with the condition experience 10 or more bowel movements daily.

Other symptoms may include:

The underlying cause of this condition is unknown.

Possible causes may include:

Some evidence suggests a connection between lymphocytic colitis and celiac disease.

Additionally, genetics may play a role.

Evidence suggests that lymphocytic colitis does not increase a person’s risk of developing colon cancer.

However, without treatment, symptoms will continue and may lead to:

A doctor will review a person’s medical history, family history, and symptoms when attempting to make a diagnosis. They will also perform a physical examination.

If they suspect an issue with the intestines, they will likely order a colonoscopy to investigate.

A doctor is unlikely to see the inflammation resulting from lymphocytic colitis during a routine colonoscopy. Instead, the colon will typically look healthy.

To diagnose lymphocytic colitis, a doctor will need to take a biopsy during a colonoscopy for examination under a microscope.

The doctor will confirm the diagnosis if the tissue shows an increased amount of white blood cells known as lymphocytes and a thickened band of collagen.

Treatment can vary depending on the severity and suspected cause of the diarrhea.

Some common treatment approaches include:

  • use of bulk-forming agents, such as psyllium
  • various antidiarrheal medications, such as loperamide and diphenoxylate
  • bile acid binders, such as cholestyramine
  • bismuth subsalicylate

The most common form of treatment is budesonide (Entocort), a type of corticosteroid. This medication helps reduce inflammation and symptom severity with minimal side effects.

In some cases, a doctor may recommend a person stop taking certain medications. Because NSAIDs may cause or aggravate symptoms, people may need to stop using them.

Diarrhea may also respond to dietary changes. A doctor may recommend a person avoid or reduce their intake of:

  • fatty foods
  • alcohol
  • spicy foods
  • caffeine
  • sugary drinks
  • beans, cabbage, carbonated beverages, or other foods that promote gas development

A person may find eating smaller, more frequent meals helpful. They may also find that eating softer, easier-to-digest foods, such as rice or bananas, reduces symptoms.

Ulcerative colitis is another form of IBD that can cause similar symptoms. However, doctors know that an abnormal immune system response causes it.

It can result in potential complications, such as the development of colon cancer, while lymphocytic colitis does not appear to, based on current studies.

A doctor can often see inflammation resulting from ulcerative colitis during a colonoscopy. However, they will need to view biopsied tissue under a microscope to see the inflammation resulting from lymphocytic colitis.

Below are answers to some common questions about lymphocytic colitis.

What can cause lymphocytic colitis?

Experts do not know the exact cause of lymphocytic colitis. It may result from one or more of the following:

  • bacterial toxins
  • a response to viruses or bacteria
  • an autoimmune response
  • use of NSAIDs

Can doctors cure lymphocytic colitis?

Treatment can help manage symptoms.

What foods should people with lymphocytic colitis avoid?

People may find that avoiding the following foods helps reduce symptoms:

  • spicy foods
  • carbonated beverages
  • beans and other foods that cause gas
  • fatty foods
  • alcohol
  • caffeine
  • sugary drinks

What are the early signs of lymphocytic colitis?

The condition typically causes chronic, watery diarrhea that can range in severity.

Lymphocytic colitis is a form of IBD that causes chronic diarrhea. It may also cause urgency issues and abdominal pain.

Left untreated, the condition can lead to complications, such as dehydration or nutritional deficiencies. However, it is not a risk factor for colon cancer, unlike ulcerative colitis and Crohn’s disease.

Treatment tends to focus on reducing diarrhea episodes and may involve antidiarrheal medications and changes to diet, including avoiding certain foods and eating smaller meals throughout the day.