Right biopsy protocol for microscopic colitis: Reduced workload and carbon footprint while maintaining diagnostic accuracy

作者：Leung E, Alshareefy Y, Costigan C, Sihag S, Delaney S, O'Donnell S, Breslin N, O'Connor A, Ryan B, Zaheer A, Cretu I, O'Hara F, McNamara D · 发表于：World journal of gastrointestinal pharmacology and therapeutics · 年份：2026 · DOI：10.4292/wjgpt.v17.i2.113874 · 被引用次数：14

BACKGROUND: Histological findings of microscopic colitis (MC) are patchy, with potential for missed diagnoses. While guidelines recommend biopsies from the right and left sides of the colon, the optimal approach remains uncertain. AIM: To interrogate diagnostic biopsies in a cohort of patients with confirmed MC with a view to improving biopsy protocols. METHODS: We conducted a retrospective study of index colonoscopies in patients with MC over a 14-year period. We recorded demographics, symptoms, total number and location of biopsies, and whether they revealed features of lymphocytic or collagenous colitis. RESULTS: A total of 228 index colonoscopies were included: 64% (145/228) lymphocytic colitis and 36% (83/228) collagenous colitis. The median age at diagnosis was 60 (interquartile range: 48-72) years, with 27% (61/228) aged < 50 years. Overall, 71% (162/228) of the patients were female, similar across subtypes. Males were older at diagnosis than females (62 vs 56, P = 0.03). Symptoms were known in 86% of patients (196/228), of whom 98% (192/196) had diarrhea. Among 150 cases with biopsies from the right colon, MC features were present in the right-colon specimens in 100%, with a patchy distribution in only 2% (3/150). In contrast, among 158 cases with biopsies from the left colon, MC features were present in the left-colon specimens in 92%. Among cases with paired right and left biopsies, 10% (13/136) had positive right-sided biopsies with negative left-sided biopsies;...