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Treatments and drugs
By Mayo Clinic staffMicroscopic colitis may get better on its own without treatment. But when symptoms persist or are severe, treatment may be necessary to relieve them. Doctors usually try a stepwise approach, starting with the simplest, most easily tolerated treatments.
Diet and medication changes
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. Foods that contain less fat and are low in fiber may help relieve diarrhea.
- Discontinue any medication that might be a cause of your symptoms. Your doctor may recommend a different medication to treat an underlying condition.
Medications
If signs and symptoms persist, your doctor may recommend:
- Anti-diarrhea medications
- Medications that block bile acids, which can contribute to diarrhea
- Steroid or anti-inflammatory medications to help control colon inflammation
- Medications that suppress the immune system to help reduce inflammation in the colon
Surgery
When the symptoms of microscopic colitis are severe, and medications aren't effective, your doctor may recommend surgery to remove all or part of your colon. Surgery is a rare treatment for microscopic colitis. It is imperative that other causes of diarrhea be excluded before surgery is considered.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Nov. 4, 2012.
- Collagenous colitis and lymphocytic colitis. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/collagenouscolitis/index.aspx. Accessed Nov. 4, 2012.
- AskMayoExpert. Are lymphocytic and collagenous colitis treated similarly? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009.
- Pardi DS, et al. Microscopic colitis. Reviews in Basic and Clinical Gastroenterology and Hepatology. 2011;140:1155.
- AskMayoExpert. Does surgery have a role in management of microscopic colitis? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009.
- Chetty R, et al. Lymphocytic and collagenous colitis: An overview of so-called microscopic colitis. Nature Reviews Gastroenterology and Hepatology. 2012; 9:209.
- AskMayoExpert. Should all patients with microscopic colitis be tested for celiac disease? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009.
- Nutrition therapy for diarrhea. Nutrition Care Manual. American Dietetic Association. https://docs.google.com/viewer?a=v&q=cache:kL8NLFTBEt8J:nutritioncaremanual.org/vault/editor/Docs/DiarrheaNutritionTherapy_FINAL.pdf+nutrition+therapy+for+diarrhea&hl=en&gl=us&pid=bl&srcid=ADGEEShCAF64UkfWELX-_iienWkqA6SM2sk2HKe8HmEr5fOT-ZLzW9hbdwSoOuVhxjn4IykLy1popBOTKYxVT2hrPhqImrzpW_kzIhxffQ5ZNDkMp_lwP13vX8Xl1FmjaWJ5QDNzHQBg&sig=AHIEtbQw86uZbSC8HTTPMg8rQFWkFBHbPA. Accessed Nov.4, 2012.
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