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: karen, 35-44 Female (Patient) Published: January 15

I've been diagnosed with microscopic colitis (15 years ago). I have no medication as of now, as loperamide bunged me up throughout the day but kept me awake all night. I'm constantly on the toilet at least 10 or 15 times a day still, and I may as well say I have watery stools. I'm used to it and I live with it unless I'm on holiday, etc. I mentioned an allergy test but the doctor said I am allergic to almost most foods, hence my colitis. The only thing that has worked is steroids on a temporary basis.

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Comment from: patcher, 55-64 Female (Patient) Published: February 09

I have been suffering with chronic diarrhea for several years and taking up to 3 Imodium a day to control it. My family doctor suggested I try Align and to stop taking any ibuprofen or aspirin based products. In the interim I had a colonoscopy and the biopsy showed I have lymphocytic colitis. Well, the Align, a probiotic, really worked. I have not taken an Imodium since I started taking Align. I steer clear of ibuprofen. It has been 2 months now that I have been diarrhea free, so I will keep my fingers crossed. Based on my reading, a gluten and lactose free diet would be beneficial as well. Celiac runs in my family.

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