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: AmyoftheLakes, 45-54 Female (Patient) Published: May 24

I woke up Monday morning (05/16/16) with severe vomiting. This was not too surprising as both my sons had been hit previously with norovirus infection that seemed to last one day only. Monday, I had nausea all day. I hadn't read the advice to stay home for up to three days so I took the day off to spend with my daughter on Tuesday, shopping and eating a light meal. I have not vomited again since Monday, but I have had the liquefied diarrhea. At least I could make it to the toilet. I worked again Wednesday but was exhausted. Thursday I worked a half day but even after a few hours' rest I could not go out to take photos in the evening as I was supposed to. Friday I worked approximately a half day. Saturday, I had to work throughout the day to make up for all I missed. I have been able to tolerate mostly bland foods still with regular dinner foods in small amounts only and except for a banana milkshake last night, I am staying away from dairy for the most part still, as well as anything too spicy, acidic. As my first and worst vomit came from last Sunday night's sloppy joes, I have an aversion to anything with ground beef at this time, almost a full week later. I am sure that will get better with time but I feel I won't be back to normal eating for several more days at least.

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Comment from: bmb, 65-74 Female (Patient) Published: July 01

I was diagnosed in 2012 with microscopic colitis. I went off all dairy and eliminated all artificial sweeteners. Just prior to the start of the colitis I was on Naprosyn (800 mg) for bursitis in my hip. I believe this was the trigger. I have not had any anti-inflammatory pain relievers since 2012 (not even an aspirin). I have been advised to use only Tylenol and only when really necessary. Imodium was key to resolving this condition. This is a lifelong journey and I believe we must all find our way, not always easy to do.

Was this comment helpful?Yes

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