Pharmacotherapy for microscopic colitis.
Microscopic colitis is a common cause of chronic watery diarrhea. Its etiology is unknown, but use of nonsteroidal antiinflammatory drugs, aspirin, and lansoprazole may be risk factors for developing the disorder. Therapy is directed primarily at resolving the symptoms of microscopic colitis; bismuth subsalicylate, aminosalicylates, traditional corticosteroids, and budesonide have been evaluated. Compared with other therapies, budesonide has the strongest evidence for effectiveness in decreasing the volume and frequency of stools and improving the quality of life; it is, however, a costly drug. We reviewed all available primary English-language literature accounts of treatment of microscopic colitis. We performed searches of MEDLINE and International Pharmaceutical Abstracts, as well as reviewing the bibliographies from key articles, to procure pertinent reports. Microscopic colitis can be successfully treated with pharmacotherapy. Based on cost and adverse-effect profiles, antidiarrheals and bismuth subsalicylate are reasonable first options, but many patients may require budesonide to achieve remission.
Wall
Geoffrey C
GC
Department of Pharmacy, Iowa Methodist Medical Center, and College of Pharmacy and Health Sciences, Drake University, Des Moines, Iowa 50311-4505, USA. geoff.wall@drake.edu
Schirmer
Lori L
LL
Page
Michael J
MJ
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use*; D002792:Cholestyramine Resin / Q000627:therapeutic use; D046728:Colitis, Microscopic / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008139:Loperamide / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D012459:Salicylates / Q000627:therapeutic use; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D009942:Organometallic Compounds; D012459:Salicylates; D002792:Cholestyramine Resin; D019819:Budesonide; C015715:bismuth subsalicylate; D008139:Loperamide; D001729:Bismuth