The frequency of mıcroscıpıc colıtıs and the level of cytokıne ın patıent wıth ırrıtable bowel syndrome

Introduction: Microscopic colitis characterised by abdominal pain and diarrhea, is a clinical entity diagnosed only by biopsy due to mucosa is always totally normal in endoscopic investigation. If biopsy wasn?t taken when patients refer to hospital with symptoms of abdominal pain and diarrhea, the irritable bowel syndrome can be diagnosed in those patients. These effects negatively to patient approach.Aim: Our aim is to investigate the frequency of microscopic colitis in constipation and diarrhea dominat IBS patients diagnosed according to Roma III criteria and the relation between cytokine levels in microscopic colitis and IBS subtypes.Patients and Methods: In this study, patients diagnosed as IBS were included. These patients were divided into two category as IBS diarrhea dominant (IBS-D) and IBS constipation dominant (IBS-C) according to Roma III criteria and the Bristol stool scala. All patients were went to colonoscopy and biopsies were taken from five different regions (caecum, ascending colon, transverse colon, descending colon and rectosigmoid region) and histopathological investigation were made. In addition to this, patient?s peripheric blood samples were taken for serum TNF-?, IL-1ß and IL-6.Findings: From 89 patients taken to the study, 40 were IBS-D and 49 were IBS-C. When IBS-D and IBS-C grups were compared, there were no statistically significant difference with age and sex. Although patient?s IBS symptom time was 28.89±14.80 months in microscopic colitis diagnosed group, in the microscopic colitis undiagnosed group the time was 50.67±50.72 months.Nine (22,5%) patients in IBS-D group and 10 (20,4%) patients in IBS-C group, microscopic colitis were diagnosed. In all patients diagnosed as microscopic colitis, rectosigmoidal region was uninvolved.Results: In our study, between IL-1ß, IL-6 ve TNF-? levels and microscopic colitis, no statistically significant difference were found. TNF-? leves were statistically significantly high in IBS-C group (p=0,013).Discussion: In IBS patients MC frequency are high according to normal population. In our study, diarrhea and constipation symptom dominant IBS patients, there were no significant difference for microscopic colitis diagnosis. Since in long-time symptomatic patients, microscopic colitis frequency are high, rectosigmoidal regional biopsy is not enough to exclude diagnosis.