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- Patient Comments: Microscopic Colitis - Treatments
- Patient Comments: Microscopic Colitis - Cause
- Patient Comments: Microscopic Colitis - Symptoms
- Patient Comments: Microscopic Colitis - Prognosis
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- What is colitis?
- What diseases are not colitis?
- What is microscopic colitis?
- What causes microscopic colitis?
- What are the symptoms of microscopic colitis?
- How common is microscopic colitis and who is at risk?
- When should I seek medical care for microscopic colitis?
- How is microscopic colitis diagnosed?
- What is the treatment for microscopic colitis?
- Can microscopic colitis be prevented?
- What is the prognosis of microscopic colitis?
What is the treatment for microscopic colitis?
The treatment of microscopic colitis has not been standardized because there have not been adequate large scale, prospective, placebo controlled treatment trials. The following strategies are safe and may relieve diarrhea in some patients:
- Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) and the other drugs mentioned under causes of microscopic colitis.
- Trial of lactose elimination (just to eliminate the possibility that intolerance to lactose in milk is aggravating the diarrhea)
- Antidiarrhea agents such as loperamide (Imodium) or diphenoxylate and atropine (Lomotil)
- Bismuth subsalicylate (Pepto-Bismol)
- 5-ASA (mesalamine) compounds such as Asacol, Pentasa, or Colazal
Controlled trials showed that budesonide (Entocort, a poorly absorbed steroid) is effective in controlling diarrhea in more than 75% of the patients with collagenous colitis, but the diarrhea tends to recur soon after stopping Entocort.
Though data supporting their use is lacking, some doctors may use medications that potently suppress the immune system such as azathioprine (Imuran, Azasan) and 6-mercaptopurine in patients with severe microscopic colitis that is unresponsive to other treatments.
Can microscopic colitis be prevented?
Since the cause of microscopic colitis is not known, no advice can be provided about preventing this disease.
What is the prognosis of microscopic colitis?
The long term prognosis (course) of microscopic colitis is not clear. In approximately two-thirds of the patients with microscopic colitis, the diarrhea resolves spontaneously after several years. The remaining one-third of the patients with microscopic colitis experience persistent or intermittent diarrhea and/or abdominal pain for many years (possibly indefinitely) as there is no cure for the condition.
Medically reviewed by Joseph Palermo, DO; American Osteopathic Board Certified Internal Medicine
MedscapeReference.com. Collagenous and Lymphocytic Colitis.
R H Riddell, M Tanaka, and G Mazzoleni. Non-steroidal anti-inflammatory drugs as a possible cause of collagenous colitis: a case-control study. Gut. 1992 May; 33(5): 683–686.