How is microscopic colitis treated?

Microscopic colitis can get better on its own, but most patients have recurrent symptoms.

The main treatment for microscopic colitis is medication. In many cases, the doctor will start treatment with an antidiarrheal medication such as Pepto-Bismol® or Imodium® .

Other medications the doctor can prescribe include:

  • Corticosteroids, man-made drugs that closely resemble cortisol (a hormone that your adrenal glands produce). Steroids work by decreasing inflammation and reducing the activity of the immune system. The two steroids most often prescribed for microscopic colitis are budesonide (Entocort®) and prednisone. Budesonide is believed to be the safest and most effective medication for treating microscopic colitis.
  • Cholestyramine resin (Locholest®, Questran®), which blocks bile acids
  • Antibiotics
  • Mesalamine (Apriso®, Asacol®) and sulfasalazine (Azulfidine®) to reduce swelling
  • Medications that work on the immune system, such as mercaptopurine (Purinethol®), azathioprine (Azasan®, Imuran®), and methotrexate (Rheumatrex®, Trexall®)
  • Tumor Necrosis Factor (TNF) inhibitors such as infliximab (Remicade®) and adalimumab (Humira®)

The doctor may also recommend that you avoid certain foods, such as caffeine or artificial sugars.

As a last resort when medications are not working, the doctor may recommend surgery to remove part or all of the colon.

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