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Treatments and drugs
By Mayo Clinic staffMany cases of collagenous colitis and lymphocytic colitis get better on their own without treatment. However, when the signs and symptoms are serious, treatment may be necessary. Treatment is the same for both collagenous colitis and lymphocytic colitis. Doctors usually recommend a stepwise approach, starting with the simplest, most easily tolerated treatments. The goal is to produce the relief of symptoms.
Diet and medication changes to relieve diarrhea
Treatment usually begins with changes to your diet and medications that may help relieve persistent diarrhea. Your doctor may recommend that you:
- Eat a low-fat, low-fiber diet. Choose foods that contain less fat and foods that are low in fiber. This may help relieve diarrhea.
- Avoid NSAID pain relievers. If you regularly take over-the-counter pain relievers thought to contribute to collagenous colitis and lymphocytic colitis, your doctor may recommend a different medication.
Medications
If your signs and symptoms persist, your doctor may recommend medications, such as:
- Anti-diarrhea drugs. Medications that control diarrhea include loperamide (Imodium A-D), bismuth subsalicylate (Pepto-Bismol) and a combination of the drugs diphenoxylate and atropine (Lomotil).
- Drugs that block bile acids. The drug cholestyramine (Questran) may help treat lymphocytic colitis by absorbing bile acids that can contribute to diarrhea.
- Steroid medications to block inflammation. A corticosteroid drug, such as budesonide (Entocort) or prednisone, can help control inflammation in your colon.
- Anti-inflammatory drugs. Other drugs used to control colon inflammation include mesalamine (Asacol, Pentasa, others) and sulfasalazine (Azulfidine).
- Drugs that suppress the immune system. Immunosuppressive drugs that can help reduce inflammation in the colon include methotrexate (Rheumatrex) and azathioprine (Azasan, Imuran).
Surgery to remove a portion of your colon
When the symptoms of collagenous colitis and lymphocytic colitis are severe, and medications aren't effective, your doctor may recommend surgery to remove all or part of your colon in a procedure called a colectomy. Surgery is rare for these conditions.
- Wald A. Other diseases of the colon and rectum. In: Feldman M, et al. Sleisinger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa.: Saunders; 2010. http://www.mdconsult.com/book/player/linkTo?type=bookHome&isbn=978-1-4160-6189-2&eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&uniq=200844987-3. Accessed Aug. 31, 2010.
- Collagenous colitis and lymphocytic colitis. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/collagenouscolitis/index.htm. Accessed Aug. 31, 2010.
- Dietrich CF. Lymphocytic and collagenous colitis (microscopic colitis). http://www.uptodate.com/home/index.html. Accessed Sept. 1, 2010.
- Tangri V, et al. Microscopic colitis: An update. Journal of Clinical Gastroenterology. 2009;43:293.
- Chande N, et al. Interventions for treating microscopic colitis: A Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Review Group systematic review of randomized trials. American Journal of Gastroenterology. 2009;104:235.
- Nutrition therapy for diarrhea. Nutrition Care Manual. American Dietetic Association. http://nutritioncaremanual.org/index.cfm. Accessed Sept. 2, 2010.
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