Types of Colitis: Microscopic vs. Ulcerative Explained

Author's Bio: Marcie Vaske, MS, LN, CNS

Hi, and welcome back to our channel.

Today we're going to be talking about microscopic and ulcerative colitis.

I will explain the risk factors along with common symptoms and signs of both of these conditions, as well as any treatment options, and are there diet and lifestyle changes that can help support.

But before we dig into it, my name is Marcie Vaske and I'm a Functional Licensed Nutritionist with Oswald Digestive Clinic. At Oswald Digestive Clinic, we really support people who have a lot of gut issues, and I'm going to link our website here where you can easily make an initial appointment. I will also link our free guide, which is Five Ways to Improve Your Gut Health. So with both of those options, maybe we'll see you in the clinic, and if not, maybe you'll be learning more about your gut with our free guide.

[Video Transcript Below Video - it is the same information]

What Is Colitis?

So digging back into the topic of colitis. So colitis really encompasses a large amount of conditions that are connected to inflammatory bowel disease, and underneath that is just an inflammation of our gastrointestinal tract that can really cause a lot of symptoms and a lot of complications.

Types of Colitis

Now, there are several forms of colitis, but the two main or primary types of colitis is microscopic colitis and ulcerate of colitis. And understanding the difference between those two can help with your treatment plan and also dietary needs as well as any lifestyle changes.

So the primary difference between ulcerative colitis and microscopic colitis is that ulcerative colitis is found in the colon in the mucosal lining. Now, this is where we have ulcers that can be seen during a colonoscopy, for example, versus microscopic colitis where those types of ulcerations are only seen under the microscope.

Symptoms and Complications

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So now that we know the primary difference between the two with microscopic colitis, a lot of times is overlooked and it's often overlooked because there's really subtle symptoms.

It may just be chronic diarrhea. So to get a proper diagnosis of this, of having microscopic colitis, it usually you need to get a biopsy to inspect the tissue and to know if you actually have this. So within microscopic colitis we have two different types. One is collagenous colitis and the other is lymphatic colitis.

Now, collagenous colitis is really marked by a thickening of the tissue within the colonic epithelium. With lymphatic colitis, there is actually an increase in lymph air in lymphocytes within the mucosal lining. Now, as I said, with microscopic colitis, a lot of times the symptom is chronic diarrhea with no blood. And with this we can also see other complications such as malabsorption issues and even weight loss due to that.

And then we have ulcerative colitis. And ulcerative colitis is going to be much more severe and need a lot more attention. What can happen is that we can find ulcers from the rectum all the way through the entire intestinal tract. And so this needs to be monitored well and with diet and lifestyle changes that it can also help support any symptoms. The primary symptoms of ulcerative colitis can be pretty life-changing. Oftentimes it's presented with bloody diarrhea and a very urgent, more urgency to have to go to the bathroom, and you can have multiple bowel movements a day.

Now there are complications that will or can arise with untreated ulcerative colitis symptoms that may be a perforation of the colon. Also toxic mega colon as well as just an increased risk of colon cancer.

So both of these types of issues in terms of microscopic colitis and ulcerative colitis are pretty severe and can have life-changing effects, especially if they are untreated.

And so a question may be, well,

What are the causes and risk factors for colitis?

And there are several. So we'll start with number one, which is genetic factors. So if you do have a family history of any kind of IBD inflammatory bowel disease issues going on, you may be more at risk for either of these conditions. There's also environmental triggers. So if you have a diet that is in high, you're eating a lot of highly processed foods and lots of sugar, let's say sodas, all the things pretty much a standard American diet, you can be at more of a risk for either of these colitis conditions.

In addition, things such as infections. So if you have had a severe infection, you may be more at risk and individuals who use chronic NSAIDs, so if you're using a lot of ibuprofen to treat another condition that you have in excessive amounts, that does put you at a bigger risk for inflammatory bowel diseases.

Another cause is going to be an immune system dysfunction, and this is where your immune system actually attacks healthy cells in your colon, creating ulcers. We see the immune system function or dysfunction actually more in ulcerative colitis. So we understand now what some of these causes of IBD can be, but what are some symptoms? And I did cover them briefly above, but just as a recap, microscopic colitis symptoms can look like chronic diarrhea, weight loss, and nutrient malabsorption.

You may also feel very fatigued. And with that you can have a lot of abdominal discomfort. So there's a few varying symptoms, but if you're having them chronically, you need to have that examined by a health practitioner.

Now with ulcerative colitis, kind of a gold standard, there is going to be the bloody chronic diarrhea urgency to have to go to the bathroom. So you're having multiple bowel movements a day, and along with that, oftentimes abdominal discomfort.

Testing and Diagnosis

Now, in addition to those symptoms, we can have systemic symptoms which may present as fever or chronic fatigue or as I mentioned, like weight loss. So if you are sitting here listening and you're thinking, well, that sounds a lot like me, what do I do next? And it's very important that you go into a gastroenterologist and have some testing done. It's always wise to rule out any physical issues before you start working with diet and lifestyle. We have to know what we're working with so to speak. And so if you're having a lot of that going on, go in, they'll do the imaging colonoscopies, biopsies to give you an answer about what is happening.

If you've been diagnosed with this, the next step is changing your diet and your lifestyle to support any other maybe medicinal type treatments that you've had to be put on. And so with that, what does it look like? So dietarily, it may look a little bit different for a lot of people just depending on what your specific symptoms are and how you are doing. But number one, we have to think about just triggers of a flare. So oftentimes you'll have a quiet time and then you'll go through an event and it become the symptom or the colitis will be flaring. And so first with lifestyle, a lot of times the trigger is going to be stress. And so thinking about changing your stress function in your life, which I know I talk about all the time on every single video, but stress is such a component to gut health. And so if you are struggling with IBD, I would strongly suggest finding what's stressing you out or what is keeping chronic stress on your shoulders and finding ways to relieve that.

So whether it's walking or meditation or working out or just quiet time in general, even 10 or 15 minutes would be sometimes enough, finding things that kind of reset you and so you're not carrying that stress, which could impact your intestinal tract. Other things would include sleep, and just as important as stress is to keep at a minimum for gut health. So asleep, if you're not getting enough sleep, you're stressing about sleep because you're not sleeping, all the things right. Our body cannot repair and reset if we are not getting enough sleep. That's very important.

I think in addition to both of those things which are very impactful, then it comes down to what are you eating? And oftentimes if you're in a flare, if you're having the chronic diarrhea and you really need to slow things down, you need to just bring the diet back into simplistic foods.

Oftentimes when I have clients, I will suggest digestive enzymes, which can be helpful for some, not all, but that helps to break the food down. And so slowing down digestion in addition to that, changing some of the foods for a bit. So doing more of a moderate protein, some nice healthy starchy carbs and more moderate fats, healthy fats so that we're not having too much vegetable, too much fruit, some but not a lot while you're going through a flare because of the disease, it will change. And so a lot of times it's kind of using diet to calm the symptom down, obviously, but also you'll get back to normal eating. And normal eating would be getting rid of processed packaged foods and consuming more whole real foods and really using diet or food as your medication as well as fuel for your body.

Oftentimes with IBD, there are medications on board for individuals and it's different, but using these lifestyle and diet techniques in conjunction with that can be so supportive. And so it's not just about taking medication to keep it at bay, it's about how can you heal? And I think once you get through a flare and you're eating your backup to having more regular foods instead of just more soft, bland foods, that's where we can do a lot of healing. And there's also supplement support for healing.

And so if you are struggling with this, if you know someone who's struggling with ulcerative or microscopic colitis, have them make an appointment with the clinic because everybody really is an individual with how they present with symptoms and how frequent flares are, and there's so many different points that we need to touch on to help support you as a whole person.

So I hope this shared a little bit of information about what colitis is all about and the difference between the two because we do oftentimes only hear about ulcerative colitis. And again, if this resonates with you or somebody that's struggling with this, share our link to the client down below and we will help them.

So thanks for watching today.

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If you'd like to explore any of this information further or obtain an individualized nutrition plan, you can schedule an initial appointment at our clinic. We also take insurance and some of our clients get full coverage, which is great.