Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
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Original Article

Volume 10, Number 6, December 2017, pages 329-333

Medical Treatment for Microscopic Colitis: A Community Hospital’s Experience


Table 1. Demographics of Patients With Biopsy Confirmed Lymphocytic, Collagenous or Microscopic Colitis
ALLTreatedPost-therapy 1
CC: collagenous colitis; LC: lymphocytic colitis; MC: microscopic colitis; RA: rheumatoid arthritis; SLE: systemic lupus erythematosus; BMs/D: bowel movements per day.
Number11451% (58/114)-
  CC77% (88/114)81% (47/58)-
  LC16% (18/114)15% (9/58)-
  MC7% (8/114)3% (2/58)-
Race/Caucasian97% (113/114)--
Gender/female88% (111/114)86% (50/58)-
Average age69 ± 1369 ± 11-
Associated autoimmune diseases (RA n = 3, SLE n = 2, psoriasis n = 1, Hashimoto’s thyroiditis n = 1, temporal arteritis n = 1)7% (8/114)--
Average BMs/D5.0 ± 3.35.1 ± 3.42.9 ± 2.4


Table 2. Patients Starting on Therapy
Patients on therapy58
Unknown start date4
Therapy started prior to colonoscopy13
Therapy started on day of colonoscopy8
Therapy started after colonoscopy33


Table 3. Patients on Therapy, Type, Change and Reason for Change
Number of patientsTherapy 1Daily dose (mg)Number of patientsΔ→ Therapy 2Daily dose (mg)Number of patientsΔ→ Therapy 3Daily dose (mg)
BID: twice daily; TID: three times daily; QID: four times daily; ND: not documented; PRN: as needed.
29Budesonide724% (7/29)3
18Budesonide91Insurance/change brand91Non-compliance/budesonide9
Budesonide91Wean off/5-ASA--
Budesonide919 → 3 taper failure/5-ASA2,4001Failure/prednisone?
8Budesonide619 → 3 taper failure/ 5-ASA4,500--
Budesonide61Mild symptoms/diphenoxylate/atropine2.5/0.025 TID--
135-ASA538% (5/13)3
45-ASA1,2001Failure/prednisone401Side effects/budesonide6
35-ASA1,6001Failure/budesonide9 → 61Remissio/5-ASA2,400
5Diphenoxylate/atropine2.5/0.025480% (4/5)
3Bismuth subsalicylate262133% (1/3)
1Bismuth subsalicylateBID1Budesonide6--
1Bismuth subsalicylateTID-----
1Bismuth subsalicylateQID-----
3Antibiotics266% (2/3)
1Metronidazole500 TID1Liprofloxacin500 BID--
2Metronidazole + ciprofloxacin500 TID/500 BID1Loperamide4 PRN--
2Hyocyamine0.125 QID-----
1Fiber6001100% (1/1)dicyclomine201Failure/loperamide2


Table 4. Average Reduction of Bowel Movements per Day for Budesonide and 5-ASA
TherapyBudesonide5-ASA (Mesalamine)
BMs/D: bowel movements per day.
BMs/D reduced →4.7 → 2.45.8 → 2.8


Table 5. Symptoms Exacerbation Ratios, Therapies Used Before and After Exacerbations
Symptom exacerbation11/58 (19%)Improved/resolved
While on 5-ASA(3/11)Change to budesonide 9 mg/day
(1/11)Change to prednisone 10 mg/day
While on budesonide 9 mg/day(3/11)Change to 5-ASA
Lowering budesonide 9 mg to 3 mg(2/11)Increase budesonide to 9 mg
While on budesonide 3 mg/day(1/11)Increase budesonide to 9 mg
Discontinuation of budesonide 9 mg/day (given for 1 month)(1/11)Restarted budesonide 6 mg/day × 1 month, then 3 mg/day