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Drug Treatment for Collagenous Colitis

Collagenous colitis is a chronic condition that causes loose, watery diarrhea. It is considered an inflammatory bowel disease because it is caused by inflammation in the colon. Collagenous colitis is often grouped together with lymphocytic colitis and called microscopic colitis because diagnosis cannot be made without a biopsy and microscopic examination. The condition is more common in older adults, and collangenous colitis is more common in women than men. Most cases resolve without treatment, but some people may require drugs or medical procedures.

  1. Anti-diarrheal Drugs

    • Doctors will often first ask patients to make lifestyle changes, such as dietary adjustments, that can improve collagenous colitis symptoms. When these changes are not effective, a doctor may prescribe an anti-diarrheal medication such as Imodium or Lomotil. These medications slow down bowel contractions that move stool through the colon, which can help ease the symptoms of collagenous colitis. These medications are considered an effective treatment for people suffering from mild or moderate diarrhea, and most can use them without any serious side effects.

    Pepto-Bismol

    • When anti-diarrheal medications do not effectively control the diarrhea associated with collagenous colitis, your doctor may recommend trying Pepto-Bismol. The active ingredient in it, bismuth subsalicylate, can help ease the bowel and colon irritation that leads to diarrhea.

    Anti-Inflammatories

    • When other drug treatments do not work to control collagenous colitis, an anti-inflammatory drug may be prescribed to control inflammation in the colon. The first choice is typically a corticosteroid, such as budesonide, or in more severe cases, prednisone. Corticosteroids can cause serious side effects such as thinning skin when used over long periods of time, so they can only be used for short periods, usually no longer than two months. Other options for anti-inflammatory drugs include methotrexate, mesalamine and sulfasalazine.

    Other Treatments

    • In severe cases of collagenous colitis in which drug treatment is not effective, surgery may be necessary to remove parts of the colon damaged by inflammation. It's important to note, however, that surgery is very rarely used as a treatment for the condition because other treatments are usually effective.

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