Colectomy in microscopic colitis: a rare indication

We read with great interest the systematic review by Honap et al 1 and commend the authors for highlighting the elevated risk of colectomy in patients with acute severe UC. While there is ample knowledge about colectomy as a last resort treatment in UC,2 little is known about the colectomy risk in microscopic colitis (MC).3–6 As the incidence of MC has been on the rise over the past decades,7 with current incidence rates (IRs) rivalling those of UC and Crohn’s disease,8 knowledge on the risk of colectomy in patients with MC is warranted. Leveraging the nationwide Swedish ESPRESSO histopathology cohort,9 we estimated the risk of colectomy in patients with biopsy-verified MC (diagnosed 1990–2017) compared with matched reference individuals from the general population (matched by age, sex, county of residence and calendar year). Colectomy was defined as having a corresponding surgical procedure code indicating total colectomy recorded in the National Patient Register (online supplemental table S1).### Supplementary data [gutjnl-2024-333505supp001.pdf] Follow-up began on the date of MC diagnosis (any of the subtypes of collagenous colitis or lymphocytic colitis) and on the matching date for the reference individuals. Study participants were followed until 31 December 2021 for colectomy, death, emigration or a medical …