How are microscopic colitis and gluten sensitivity (or celiac sprue) related?
I have shown in a previous study that the most common cause of diarrhea in patients with celiac sprue treated with a gluten-free diet for many years is microscopic colitis. Other individuals are found at the time of diagnosis to have both of these syndromes. this realtes to the fact that the same immune system regulatory genes, called HLA, are involved in producing both syndromes, as well as many other autoimmune syndromes. The celiac sprue diagnosed in patients found to have microscopic colitis is usually of a mild variety, and appears to me to be the result of the colitis itself. This occurs because the genes causing microscopic colitis are also programmed to react with gluten if they are triggered to do so. This is why people can go their whole lives withjout apparent gluten sensitivity and then suddenly become gluten intolerant. Thus, testing for the presence of gluten sensitivity in patients with microscopic colitis, sometimes combined with assessment for the presence of the glute
