VIDEO: Patient uncertainty about colitis diagnosis ‘speaks to need’ to better communication
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In this Healio video exclusive, Walker D. Redd, MD, discusses a study of patients with chronic diarrhea who underwent colonoscopy, which revealed 10% who had microscopic colitis “remained unaware” of their diagnosis 1 year after evaluation.
Redd, a GI fellow at the University of North Carolina at Chapel Hill, and colleagues conducted a follow-up of patients who underwent a diagnostic colonoscopy for chronic diarrhea. Patients were classified with (n = 110) or without (n = 252) microscopic colitis by a study pathologist, and were surveyed about their diagnosis, medications and symptom burden 1 year after colonoscopy. Of those who participated in the survey, 74 had microscopic colitis and 162 did not (controls).
Results from the survey showed 10% of patients with microscopic colitis did not recall or were unsure of their diagnosis. Seven percent of controls reported a diagnosis of microscopic colitis, despite no clinical documentation, and 8% of those patients were unsure of their diagnosis.
“The first finding, which was relatively surprising, was that some patients remained unaware of having been diagnosed with microscopic colitis at 1 year,” Redd told Healio. “This speaks to the need to improve communication between the endoscopist or gastroenterologist doing the procedure and the referring providers, as well as the patients, to make sure everyone understands whether or not microscopic colitis was diagnosed and what can be done to help manage symptoms, especially over the long term.”
Of patients diagnosed with microscopic colitis, 15% reported nocturnal stools, 28% abdominal pain, 40% fecal urgency, 32% weight loss and 21% fecal incontinence. These patients also were more likely to have been treated with medication vs. controls (60% vs. 26%), and nearly half (46%) were treated with budesonide.
In addition, patients with microscopic colitis had lower Microscopic Colitis Disease Activity Index scores at 1 year compared with controls.
“Those who did not have a microscopic colitis diagnosis had worse symptoms at 1 year compared with those who had been diagnosed with microscopic colitis,” Redd told Healio, noting some symptoms were significant and included urgency and incontinence.
“We need to be seeing these patients and making sure they are doing well a year out from their first endoscopic evaluation and making sure we are doing our best to help them manage their symptoms,” he said.
Redd added: “We hope that this raises some awareness about the chronicity of these symptoms, and the importance of following up with these patients longitudinally and offering specialty follow-up as needed.”
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