Can Microscopic Colitis Symptoms Be Too Mild to Notice?

By Lorra Garrick | Last updated 05/23

Can the symptoms of a microscopic colitis flare be small enough to appear below the radar?

Can the signs be so subtle that they fail to register on your awareness map?

Microscopic colitis is not an “all or none” condition.

I was diagnosed with microscopic colitis in May 2010, but does this mean that my first bout was at this time?

I really wonder, because there have been a few times way, way in the past in which I had experienced what I now know to be “explosive watery diarrhea.”

It had happened just a few times here and there over a span of years. Maybe it was something I had eaten. But maybe not.

I began juicing several years prior to my diagnosis, and noticed that on just about every juicing day, within 90 minutes to two hours after consuming an average of 32 ounces of juiced fruits and vegetables, I’d have one episode of major diarrhea.

It wasn’t watery or explosive, but it was like a thick porridge. I’d have just one occurrence, then I was done for the day.

I simply thought that all the juicing was triggering this. The diarrhea occurred only on days that I juiced.

Mild Microscopic Colitis Symptoms

“Yes – you can have microscopic colitis and not know it. You might not exhibit all the usual symptoms but still have the disease,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.

“With microscopic colitis, the colon looks completely normal until you get to the microscopic level.

“On the microscopic level, it’s abnormal. In some cases, a patient could have sub-acute symptoms. Sub-acute or milder symptoms may be harder for patients to recognize.”

My first round of microscopic colitis came and went (lasted about two months). The second round occurred about three and a half years later and lasted about five weeks.

But in between, could it have been there on a sub-acute or “low grade” level, masquerading as juicing-induced diarrhea?

I’d see particles of fruit/vegetable fragments floating around in the brown murky water of the toilet.

The diarrhea that I had with my first round of microscopic colitis did not look like typical diarrhea.

It looked really weird and came at all times of the day (including nocturnally) – even though during that time I was not juicing.

At around the beginning of 2013, I became gradually aware that I was no longer having diarrhea on juicing days; the bowel movements were normal.

This went on for months, and it really got my attention, because I was so used to the diarrhea.

“Why isn’t the juicing causing the diarrhea anymore?” I wondered. I had always thought that the fiber content in 32 to 40 ounces of juiced produce caused the diarrhea. So where was it now?

In retrospect, I’m thinking that maybe all along, it had been a very subtle manifestation of microscopic colitis, and that in 2013, I went into complete remission. Then…I had my second MC round later in the year.

Enteropathic Arthralgia Mimicking other Conditions

If you’re having subtle joint aches but no other symptoms, this, too, can be microscopic colitis, especially if you’ve already been diagnosed with MC and believe you’ve been in remission for a while.

It will be especially inconspicuous if the aching is in only one part of your body, such as only the low back.

After all, low back pain is extremely common and easily brought on by a combination of physical de-conditioning and improper lifting around the house or on the job.

The timeline could be a coincidence, when it’s really MC at work.

(Low back pain can also be brought on by physical de-conditioning alone! As a former personal trainer, I’ve witnessed this with clients who were new to exercise but complaining of low back pain.)

A subtle flare-up of microscopic colitis can also be missed by a fertile woman who’s experiencing what she believes are the minor aches of mid-cycle joint pain—when in fact, it’s enteropathic arthralgia.