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: Miss P, 45-54 Female (Patient) Published: September 23

Five years ago I started having explosive watery diarrhea after everything I ate. I did not go to the doctor for 2 years. I'm a runner so this definitely hindered my hobby somewhat. I had a colonoscopy and was diagnosed with microscopic colitis. I wondered if this is the diagnosis used when they can't figure out what is actually wrong. I tried all the medicines and the only thing that made a difference was prednisone. However, I will never be on that horrible drug again. I am wondering what this is doing to my body. I have not lost or gained any weight. My hair is dry and brittle and often breaks and falls out. I do not know if this is a side effect or possibly hormonal now that I am in the menopause years. Although I have a good doctor probably the best in my large city, I am trying to get in with another gastroenterologist at a local university. I am hoping he doesn't want his own colonoscopy to look at. Yuck! That is something else I never want to do again.

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Comment from: bells, 55-64 Female (Patient) Published: October 02

I was recently diagnosed with microscopic colitis. I did a lot of reading and learned that gluten is often the catalyst behind the diarrhea. So I totally went gluten-free, as well as almost dairy free. Within 2 or 3 weeks the diarrhea ended, and I am feeling just about normal. I had lost about 25 lb. in 2 months with the diarrhea and now my weight is remaining stable. I don't eat any junk food, and never did, and didn't eat desserts or sweets so I really don't know how I ended up with microscopic colitis. At least it can be treated by diet, and not medicine.

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