Microscopic Colitis Associated With Omeprazole and Esomeprazole Exposure

Goals: The aim of this study was to determine whether proton pump inhibitors other than lansoprazole might be associated with microscopic colitis. Background: Lansoprazole exposure has been associated with diarrhea and microscopic colitis, but this relationship has not been described with other proton pump inhibitors. Study: Cases of microscopic colitis from a consultative gastroenterology practice were collected and reviewed for proton PUMP inhibitor exposure. Standard clinical, endoscopic, and biopsy findings were analyzed. Results: A case series of 4 patients is described in which Subjects developed classic symptoms of lymphocytic-collagenous colitis with typical mucosal histopathology during treatment with omeprazole/esomeprazole. Symptoms promptly stopped and mucosal biopsies returned to normal with drug withdrawal. Disease quickly recurred in 2 patients who were reexposed to the drugs, One with biopsy documented recurrent collagenous colitis. Conclusions: Some cases of microscopic colitis seem to be associated with omeprazole/esomaprazole exposure. These results have epidemiologic, diagnostic, and therapeutic ramifications, which are discussed.