According to a Swedish study, the prevalence of microscopic colitis among patients undergoing colonoscopy for evaluation of chronic watery diarrhea is between 10% and 20%.[10]Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am J Gastroenterol. 2015 Feb;110(2):265-76.
http://www.ncbi.nlm.nih.gov/pubmed/25623658?tool=bestpractice.com
[11]Olesen M, Eriksson S, Bohr J, et al. Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993-1998. Gut. 2004 Mar;53(3):346-50.
https://gut.bmj.com/content/53/3/346.long
http://www.ncbi.nlm.nih.gov/pubmed/14960513?tool=bestpractice.com
Microscopic colitis accounts for almost 20% of cases of chronic diarrhea in patients >70 years.[11]Olesen M, Eriksson S, Bohr J, et al. Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993-1998. Gut. 2004 Mar;53(3):346-50.
https://gut.bmj.com/content/53/3/346.long
http://www.ncbi.nlm.nih.gov/pubmed/14960513?tool=bestpractice.com
[12]Münch A, Langner C. Microscopic colitis: clinical and pathologic perspectives. Clin Gastroenterol Hepatol. 2015 Feb;13(2):228-36.
https://www.cghjournal.org/article/S1542-3565(14)00002-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/24407107?tool=bestpractice.com
The estimated incidence rate of microscopic colitis worldwide is 11.4 cases per 100,000 person‐years.[6]Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021 Feb 22;9(1):13-37.
https://onlinelibrary.wiley.com/doi/10.1177/2050640620951905
http://www.ncbi.nlm.nih.gov/pubmed/33619914?tool=bestpractice.com
In the UK, the incidence is estimated to be around 18 cases per 100,000 population per year.[13]Lewis N, Archer T, Kaye. PPWE-061 Epidemiology of microscopic colitis in Nottingham: a contemporary cohort study. Gut. 2017 Jun 17;66:A156.
https://gut.bmj.com/content/66/Suppl_2/A156.1
Studies from North America and Europe suggest a rising incidence in the late 20th century.[14]Pardi DS. Diagnosis and management of microscopic colitis. Am J Gastroenterol. 2017 Jan;112(1):78-85.
http://www.ncbi.nlm.nih.gov/pubmed/27897155?tool=bestpractice.com
However, data from the early 2010s suggest that incidence rates have stabilized.[10]Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am J Gastroenterol. 2015 Feb;110(2):265-76.
http://www.ncbi.nlm.nih.gov/pubmed/25623658?tool=bestpractice.com
[15]Gentile NM, Khanna S, Loftus EV Jr, et al. The epidemiology of microscopic colitis in Olmsted County from 2002 to 2010: a population-based study. Clin Gastroenterol Hepatol. 2014 May;12(5):838-42.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3981950
http://www.ncbi.nlm.nih.gov/pubmed/24120840?tool=bestpractice.com
In North America and Europe, the incidence of the collagenous colitis subtype ranges from 0.6 to 16.4 cases per 100,000 person-years, while the incidence of the lymphocytic colitis subtype ranges from 0.6 to 16 cases per 100,000 person-years.[6]Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021 Feb 22;9(1):13-37.
https://onlinelibrary.wiley.com/doi/10.1177/2050640620951905
http://www.ncbi.nlm.nih.gov/pubmed/33619914?tool=bestpractice.com
Geographic variations in the incidence of microscopic colitis have been reported, although conclusions cannot be made due to the limited number of studies and the lack of direct comparative studies from different countries for the same time period.[6]Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021 Feb 22;9(1):13-37.
https://onlinelibrary.wiley.com/doi/10.1177/2050640620951905
http://www.ncbi.nlm.nih.gov/pubmed/33619914?tool=bestpractice.com
More than 75% of patients diagnosed with microscopic colitis are over 45 years of age.[16]Bohr J, Tysk C, Eriksson S, et al. Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut. 1996 Dec;39(6):846-51.
https://gut.bmj.com/content/gutjnl/39/6/846.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/9038667?tool=bestpractice.com
The median age at diagnosis for collagenous colitis is 64.9 years, similar to lymphocytic colitis (median 62.2 years); a raised incidence of microscopic colitis is observed with increased age.[10]Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am J Gastroenterol. 2015 Feb;110(2):265-76.
http://www.ncbi.nlm.nih.gov/pubmed/25623658?tool=bestpractice.com
Microscopic colitis can also affect children, particularly those with autoimmune diseases and those frequently taking medications associated with microscopic colitis, such as nonsteroidal anti-inflammatory drugs.[16]Bohr J, Tysk C, Eriksson S, et al. Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut. 1996 Dec;39(6):846-51.
https://gut.bmj.com/content/gutjnl/39/6/846.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/9038667?tool=bestpractice.com
However, it is very rare in pediatric populations.[4]Józefczuk J, Wozniewicz BM. Clear cell colitis: a form of microscopic colitis in children. World J Gastroenterol. 2008 Jan 14;14(2):231-5.
https://www.wjgnet.com/1007-9327/full/v14/i2/231.htm
http://www.ncbi.nlm.nih.gov/pubmed/18186560?tool=bestpractice.com
The risk of developing microscopic colitis is higher in women than men.[10]Tong J, Zheng Q, Zhang C, et al. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am J Gastroenterol. 2015 Feb;110(2):265-76.
http://www.ncbi.nlm.nih.gov/pubmed/25623658?tool=bestpractice.com
In three large studies, the average proportion of females with microscopic colitis was 72%.[17]Bonderup OK, Wigh T, Nielsen GL, et al. The epidemiology of microscopic colitis: a 10-year pathology-based nationwide Danish cohort study. Scand J Gastroenterol. 2015 Apr;50(4):393-8.
http://www.ncbi.nlm.nih.gov/pubmed/25645623?tool=bestpractice.com
[18]Verhaegh BP, Jonkers DM, Driessen A, et al. Incidence of microscopic colitis in the Netherlands. A nationwide population-based study from 2000 to 2012. Dig Liver Dis. 2015 Jan;47(1):30-6.
http://www.ncbi.nlm.nih.gov/pubmed/25455154?tool=bestpractice.com
[19]Bergman D, Clements MS, Khalili H, et al. A nationwide cohort study of the incidence of microscopic colitis in Sweden. Aliment Pharmacol Ther. 2019 Jun;49(11):1395-400.
http://www.ncbi.nlm.nih.gov/pubmed/30983010?tool=bestpractice.com
In case series, a female to male incidence ratio of 2.8 to 4.1 was reported for collagenous colitis and 1.7 to 2.6 for lymphocytic colitis.[17]Bonderup OK, Wigh T, Nielsen GL, et al. The epidemiology of microscopic colitis: a 10-year pathology-based nationwide Danish cohort study. Scand J Gastroenterol. 2015 Apr;50(4):393-8.
http://www.ncbi.nlm.nih.gov/pubmed/25645623?tool=bestpractice.com
[19]Bergman D, Clements MS, Khalili H, et al. A nationwide cohort study of the incidence of microscopic colitis in Sweden. Aliment Pharmacol Ther. 2019 Jun;49(11):1395-400.
http://www.ncbi.nlm.nih.gov/pubmed/30983010?tool=bestpractice.com
[20]Fumery M, Kohut M, Gower-Rousseau C, et al. Incidence, clinical presentation, and associated factors of microscopic colitis in northern France: a population-based study. Dig Dis Sci. 2017 Jun;62(6):1571-9.
http://www.ncbi.nlm.nih.gov/pubmed/27659673?tool=bestpractice.com