A gastroenterologist names the top five drug treatments for microscopic colitis.

To find out what these top five drug treatments are, I consulted with Matilda N. Hagan, MD, an inflammatory bowel disease specialist at The Center for Inflammatory Bowel and Colorectal Diseases, part of The Melissa L. Posner Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore.

“Budesonide is a steroid and is the best available medicine,” says Dr. Hagan. “It costs a lot even with insurance coverage; therefore some patients cannot get it. We typically treat daily for 2-3 months, then wean dosage if we achieve remission.”

Dr. Hagan then recommends anti-diarrheals such as Imodium; “Lomotil can work to slow the gut and decrease the diarrhea.”

Another drug treatment option is Pepto Bismol, which can decrease the diarrhea.

Dr. Hagan also recommends prednisone if the patient can’t get the budesonide. Prednisone may have fewer side effects.

Finally there is Mesalamine, which is an anti-inflammatory drug that’s used in the treatment of mild to moderate ulcerative colitis.

Now keep in mind that like microscopic colitis, ulcerative colitis is an inflammatory bowel disease—but just a more severe type of IBD.

If you are not comfortable taking a drug for treatment of microscopic colitis, you can experiment with your diet to see if any particular foods are triggers of flare-ups.

For instance, you may find that certain fruits seem to cause diarrhea. Eliminate the suspect food (not food group) from your diet and see what happens.

Dr. Hagan is dedicated to collaborating with IBD specialists to discuss and explore advanced treatment options for the most complex inflammatory bowel disease cases.
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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