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Lymphocytic and Collagenous Colitis: Medical Management.

Marshall1, Irvine

  • 1Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Current Treatment Options in Gastroenterology
|November 30, 2000
PubMed
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Discontinue NSAIDs and try eliminating caffeine or lactose for microscopic colitis. Aminosalicylates are first-line, with bile salt binders as alternatives. Corticosteroids are for refractory cases, and surgery is a last resort.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Colitis Research

Background:

  • Microscopic colitis is a chronic inflammatory condition of the colon.
  • Diagnosis often follows unexplained chronic watery diarrhea.
  • Current treatment guidelines are evolving based on emerging evidence.

Purpose of the Study:

  • To review and synthesize current treatment strategies for microscopic colitis.
  • To provide evidence-based recommendations for managing this condition.
  • To highlight the role of various therapeutic agents and interventions.

Main Methods:

  • Review of existing literature on microscopic colitis treatments.
  • Analysis of clinical trial data and expert opinion.
  • Synthesis of treatment efficacy and safety profiles.

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Main Results:

  • Aminosalicylates (5-ASA) are recommended as first-line therapy.
  • Bile salt-binding agents are effective alternatives for non-responders or intolerant patients.
  • Systemic corticosteroids are reserved for refractory cases due to potential side effects.
  • Discontinuation of NSAIDs is advised upon diagnosis.
  • Elimination diets (caffeine, lactose) may be considered.
  • Surgery is a last resort option for intractable disease.

Conclusions:

  • A stepwise approach to microscopic colitis treatment is recommended, starting with aminosalicylates.
  • Careful patient selection is crucial for corticosteroid use.
  • Investigating concomitant conditions like celiac disease is important in refractory cases.
  • Further research is needed for less common therapeutic agents.