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Background: Microscopic colitis (MC) is a recognized cause of chronic diarrhea and is often underestimated when a colonoscopy appears normal. This study aims to accurately diagnose chronic diarrhea through histopathological examination of colonoscopic mucosal biopsies and assess the prevalence of microscopic colitis and the diagnostic value of biomarkers. Methods: A hospital-based cohort study was conducted on 116 patients with chronic diarrhea. Colonoscopies and colonic mucosal biopsies were performed and analyzed, along with various tests including fecal calprotectin (FC) level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), stool analysis, routine laboratory tests, and clinical data related to nocturnal diarrhea, abdominal pain, and unexplained weight loss. Results: In the study group, 32.8% had MC, with 25.9% having lymphocytic colitis (LC) and 6.9% having collagenous colitis (CC). Patients with MC had significantly higher FC, ESR, and CRP levels than those without colitis (p < 0.001). Factors associated with MC included nocturnal diarrhea (OR = 4.26; 95% CI [1.64–11.08]; p-value = 0.003) and abdominal pain (OR = 4.62; 95% CI [1.85–11.54]; p-value = 0.001). ESR at a cutoff >14 mm/h and FC at a cutoff >64 mcg/g showed excellent validity in diagnosing MC with area under the curve (AUC) values of 0.94 and 0.97, respectively. Conclusions: Microscopic colitis, particularly LC-type, is not an uncommon cause of chronic diarrhea, especially when accompanied by symptoms such as abdominal pain and nocturnal diarrhea, warranting further investigation, including inflammatory markers and colonic biopsy. Inflammatory markers can be useful in diagnosing MC with proper values and approaches; however, further studies are needed. [ABSTRACT FROM AUTHOR]

Background: Ulcerative colitis (UC) is a long-standing inflammatory disease with remission and exacerbation courses. Early detection of relapses, flares, disease activity changes, and treatment responses is key to optimizing patient management. The evidence about the usefulness of low-cost blood test inflammatory markers concerning UC disease activity is still limited. This study aimed to evaluate the diagnostic accuracy of low-cost serum inflammatory markers in monitoring UC activity. Methods: This cross-sectional study was conducted in the inflammatory bowel disease (IBD) clinic, Zagazig University Hospital, Egypt. Fecal calprotectin and low-cost serum inflammatory markers including C-reactive protein (CRP), Creactive protein-albumin ratio (CAR), lymphocyte-monocyte ratio (LMR), mean platelets volume-lymphocyte ratio (MLR), mean platelets volume-platelets ratio (MPR), neutrophil-lymphocyte ratio (NLR), platelets-lymphocyte ratio (PLR), red cell distribution width-platelet ratio (RPR), and systemic immuneinflammation index (SII) were measured. Results: The area under the curve (AUC) of CRP, CAR, Fecal calprotectin, LMR, SII, and MPR in the diagnosis of severe UC were 0.85, 0.85, 0.84, 0.81, 0.83, and 0.80, respectively. CRP, CAR, Fecal calprotectin, NLR, LMR, SII, Albumin, MPR, and RPR were independent predictors for Mayo score grade 3. Conclusions: low-cost serum inflammatory markers such as CRP, CAR, LMR, SII, and MPR showed diagnostic accuracy in monitoring severe UC activity. [ABSTRACT FROM AUTHOR]

Background: apart from endoscopic intervention, cost effective biomarkers for for prediction of relapse in ulcerative colitis are needed, for treatment modulation to achieve the best outcome of these patients. Patients and methods: A cohort study carried out in Internal Medicine Department, and Immunology Departments, Faculty of Medicine, Zagazig university hospitals. All subjects submitted to full history taking, clinical examination, colonoscopy and laboratory Investigations as CRP, ESR, and fecal calprotectin. Results: There was a statistically significant increase in mean values of hemoglobin, serum albumin, and mean platelet volume with a significant decrease in mean value of white blood cell count, N/L ratio, platelet count, serum calprotectin and ESR 6 months after treatment initiation. There is statistically significant relation between outcome and CRP being higher in patients with relapse whether before or after treatment. Higher ESR level post treatment predicted relapse (p=0.039). Serum Calprotectin was significantly higher in patients with relapse after treatment (p=0.01) Conclusion: Fecal calprotectin, ESP, CRP are simple non-invasive marker can used to predict outcome in ulcerative colitis patients after treatment initiation. [ABSTRACT FROM AUTHOR]