thesis(m.s.)-Ain Shams University. Faculty of Medicine. Internal Medicine department.

include bibliographical references(p.179-249)

Background: Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders. Properly diagnosing IBS can be challenging and uncertain as there is no clinical, biological or endoscopic marker for IBS. One gastrointestinal disorder frequently misdiagnosed as irritable bowel syndrome is microscopic colitis (MC). Thus, differentiating patients with diarrhea predominant IBS from those with microscopic colitis can be challenging as MC and IBS-D have similar symptoms.
Objective: Our study is aiming to diagnose microscopic colitis in patients initially diagnosed with diarrhea predominant-IBS according to Rome IV criteria by obtaining colonoscopic biopsies with chromogranin A staining.
Methods: Our study was designed in Ain Shams university hospitals and October 6 University hospital in the period between February 2016 to December 2016. Patient was diagnosed as IBS according to the Rome IV criteria. All patients undergone full history taking, clinical examination, laboratory investigations, abdominopelvic ultrasonography, upper GIT endoscopy & colonoscopy with multiple biopsies for histopathological examination.
Results: the prevalence of MC was 10% (1/50 CC & 4/50 LC). Duration of diarrhea was not significantly higher in MC patients. MC was significantly associated with certain drugs and concomitant diseases.
Increased chrmogranin A cell density in MC.
CONCLUSION: Rome IV criteria is not sufficient for exclusion of MC. Total colonoscopy with multiple biopsies from normal appearing mucosa is recommended for every patient previously thought to have IBS-D to exclude MC.
Key Words: Microscopic colitis (MC) - Irritable bowel syndrome (IBS) –Chromogranin A cell density.

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