Microscopic colitis can be chronic or intermittent. It can also be transient, which isn’t necessarily the same as intermittent.

For example, I’ve had only two blatant rounds of a microscopic colitis flare-up over a period of three years and eight months.

The first flare-up lasted about two months. The second persisted for about five weeks.

The concept of transience and intermittency can be vague.

“Microscopic colitis flare-ups vary in length and intensity from patient to patient,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.

“Diet, exercise, sleep patterns, stress, and many other factors can affect a flare-up. It can take weeks or years to heal.

“MC flare-ups can vary from a few weeks to several years. Some factors that may help shorten a flare-up include eating a gluten-free diet and avoiding NSAIDs because they can damage the GI tract.

“Generally a three-month course of budesonide will take care of a microscopic colitis flare-up, but people who have more refractory cases may need other agents such as azathioprine and anti-TNF agents.”

The Diarrhea of Microscopic Colitis

Typically, the diarrhea is explosive. This means it bursts out of you very fast, splattering its contents all over the interior of the toilet bowl.

This burst or explosion is made possible by the high volume of water that’s mixed in with the diarrhea.

Sometimes it appears that what’s coming out of you is dark thick urine, when in fact, it’s very liquid diarrhea.

There may be severe abdominal cramping beforehand that disappears after voiding.

Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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