Microscopic Colitis - Treatments

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What was the treatment for your lymphocytic colitis?

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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: Terry, 55-64 Female (Patient) Published: March 06

I was diagnosed with C. difficile colitis 6 months ago. Before I was diagnosed I had been feeling very poorly. I was experiencing overwhelming fatigue and diarrhea. I had gone to several doctors who said I was over worked and depressed and I needed to see a psychiatrist. It was a nightmare! I decided to see my gastroenterologist. The day after I saw my gastroenterologist I became very ill with a very high fever and I became dehydrated and had to be hospitalized. The diagnosis in the hospital was bacterial colitis which was treated with antibiotics. I was in the hospital for two weeks. About three weeks after I left the hospital I went back to my gastroenterologist and he told me I had C. difficile/microscopic colitis. He gave me hyoscyamine 0.125mg for cramps and suggested I use Imodium for the diarrhea and slowly introduce more solid foods into my diet. About 5 weeks ago I began to have the colitis symptoms again and went back to him and he put me on the low FODMAP diet. I have been on the diet and eliminated all gluten and lactose products from my diet and it is getting a little better. I no longer experience diarrhea but now I get constipated and have to drink 1/4 of a (10oz) bottle of magnesium citrate so I can have a bowel movement. I have lost 20lbs in six months. I also experience pain in the center and left regions of the upper abdomen as well as my upper and lower back.

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Comment from: kW girl, 55-64 Female (Patient) Published: May 22

I was diagnosed with lymphocytic colitis in February 2014. I went on an 8 week course of Uceris. Within 24 hours my diarrhea had subsided. Six weeks after I stopped taking the drug my diarrhea returned, but I am now back on Uceris with the same result. Great drug but very expensive.

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