Lymphocytic colitis

Lymphocytic colitis is a rare inflammatory disease of the large intestine (i.e. colon) which leads to a persistent watery diarrhea. It is one of the subtypes of the disease known as microscopic colitis, the other subtype being collagenous colitis.


The precise cause of lymphocytic colitis is not yet determined. Some doctors believe it to be an autoimmune disease in which the immune system attacks our own body cells. The other possible causes of damage to colon include:

  • Bacteria and their toxins that may irritate the lining of the colon
  • Viruses that may trigger inflammation
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Improper absorption of bile acid


Lymphocytic colitis symptoms typically include:

  • Chronic, watery diarrhea without blood (diarrhea may be either continuous or episodic)
  • Abdominal pain or cramping may be present
  • Fecal incontinence
  • Weight loss
  • <liNausea

Risk factors

Age: The condition most commonly affects elderly people. Usually, lymphocytic colitis is diagnosed in people who are in their 50s.

Gender:Men and women are equally affected with lymphocytic colitis.

Genetics:There may be an association between lymphocytic colitis and family predisposition to irritable bowel syndrome.

Smoking:Smokers aged 16 to 44 years are especially at a little higher risk of getting lymphocytic colitis.


Without treatment, lymphocytic colitis can lead to the following complications:

  • Dehydration
  • Weight loss
  • Malabsorption of food and nutrients
  • Malnutrition

Unlike the other inflammatory bowel diseases, lymphocytic colitis does not increase the risk of colon cancer.

The diagnosis includes taking a complete medical and medication history and performing a physical examination.

Further, the following tests are performed:

Test typePurpose of the test
Stool culture test To rule out other gastrointestinal diseases
Blood test To check for the signs of infection or anemia
Colonoscopy A slender tube is inserted into the colon through the anus to view the colon which appears to be normal
Flexible sigmoidoscopy A thin tube is inserted through the anus to view the rectum which appears normal
Biopsy It is a definitive diagnosis of lymphocytic colitis Involves microscopic examination of the tissue samples collected from the lining of the colon The tissue sample shows increased number of inflammatory lymphocytes (i.e. white blood cells) between the cells

There is no cure for lymphocytic colitis. The microscopic colitis treatment i.e. collagenous colitis treatment and lymphocytic colitis treatment depends on the symptoms and severity of the condition. Treatment for lymphocytic colitis is discussed below:

In some patients, the disease may resolve spontaneously but in most of the patients, symptoms may reoccur.

Treatment initially involves lifestyle changes to improve diarrhea which include:

  • Taking a low fat-diet
  • Avoiding foods that contain lactose or caffeine
  • Avoiding the use of NSAID drugs such as aspirin and ibuprofen

If lifestyle changes are not providing relief from the symptoms, then medications are required. Medicines used in the treatment for colitis include:

  • Antidiarrheal agents such as bismuth subsalicylate and bulk forming drugs
  • Anti-inflammatory agents such as sulfasalazine, mesalamine, and budesonide
  • Bile acid blocking agents such as cholestyramine and colestipol
  • Rarely, treatment with immunosuppressive agents such as mercaptopurine and azathioprine may be required

If the condition is severe, then a bypass surgery of the colon or surgery to remove a part or entire colon may be performed in some patients.