Microscopic Colitis - Treatments

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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)
  • budesonide (Entocort EC)
  • 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.

Return to Microscopic Colitis (Lymphocytic Colitis and Collagenous Colitis)

See what others are saying

Comment from: Jennifer, 45-54 Female (Patient) Published: February 12

I have had shingles now for 3 weeks and the pain is vile. I have seen online that vitamins B12, E and C really help, I will try anything. I suffer osteoporosis in my spine and this is bad enough but the pain shingles has left me in my left lung is just excruciating.

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Comment from: Spice, 55-64 Female (Patient) Published: April 01

After having diarrhea for a year I was diagnosed with microscopic colitis. I was told that I could try Pepto-Bismol as a treatment but I chose not to take it. I experienced this condition for a few more years and my husband finally persuaded me to try psyllium fiber. He takes Konsyl and others take Metamucil. I chose to take fiber capsules. I have been taking them for about a week now and am very happy with the results. They really help to make my bowel movements easier and less messy!

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