Macroscopic Findings of Microscopic Colitis: Quid Videritis

A 64-year-old woman, chronic smoker presented for a colonoscopy due to symptoms of diarrhoea and weight loss; she has been on loperamide and codeine for symptoms relief. Faecal occult blood (for the National bowel screening program) and subsequent stool cultures were negative. In the ascending colon, cat-scratch mucosal lesions were seen (Figure 1a); furthermore, in the distal transverse colon a deep, fresh mucosal fracture was noted (Figure 1b). Her chest Xray and detailed biochemistry were unremarkable [1]. Biopsies were consistent with collagenous colitis.