Treatment for Microscopic Colitis: Medications, Diet, and More

Treatment for microscopic colitis usually involves medications to reduce inflammation and immune activity in the colon and lifestyle changes to reduce symptoms.

Microscopic colitis, a chronic type of inflammatory bowel disease (IBD), usually causes uncomfortable digestive symptoms, including:

• watery diarrhea, which may occur at night
• bloating
• urgency and incontinence
• weight loss
• fatigue

While there are two types of microscopic colitis, both have similar symptoms and treatment.

Treatment for microscopic colitis aims to reduce these symptoms and help you achieve remission. Remission refers to a period where disease activity and symptoms improve or go away. While treatment does not cure microscopic colitis, it helps many people enter remission. Symptoms may recur and remit long term.

Keep reading to learn about the types of treatment available for microscopic colitis, including medications, lifestyle and dietary changes, and surgery.

Doctors typically treat microscopic colitis with medication. They may initially recommend trying a medication to reduce diarrhea. If that doesn’t work, they may recommend the corticosteroid budesonide, which is commonly prescribed for microscopic colitis and effective at reducing symptoms. This medication reduces inflammation in the colon.

If budesonide does not help you achieve remission from microscopic colitis, a doctor may recommend another treatment.

These can include:

• other corticosteroid medications to reduce gut inflammation
• aminosalicylates, which can reduce gut inflammation
• antidiarrheal medicines, such as loperamide (Imodium)
• bile acid sequestrants, such as cholestyramine (Prevalite), colesevelam (Welchol), or colestipol (Colestid)
• biologics, such as infliximab (Remicade), adalimumab (Humira), vedolizumab (Entyvio), or ustekinumab (Stelara), or other immunosuppressant drugs

Doctors may also recommend certain changes to your nutrition or daily routine to promote remission from microscopic colitis. These can include:

• quitting smoking, if you smoke
• stopping medications that may contribute to microscopic colitis, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve)
• changing what you eat and drink when you experience symptoms

While there is no specific diet recommended for microscopic colitis, avoiding foods and drinks that seem to cause symptoms may help. This may include avoiding:

If you have another digestive disorder, such as lactose intolerance or Celiac disease, avoiding exposure to triggering food or drinks

If you’re experiencing diarrhea, doctors may recommend following a BRAT diet until your symptoms resolve. This diet consists of bland foods that help bind stool together:

• bananas
• rice
• applesauce
• toast

Learn more about dietary changes for microscopic colitis.

Surgery may be an option for some people with microscopic colitis if no other treatment options work to manage or reduce your symptoms.

Surgical options for microscopic colitis can include:

• colectomy, which removes all or a portion of the colon
• ileostomy, which diverts the small intestine to an opening in the skin, called a stoma, for waste removal
• J-pouch surgery, or ileal pouch-anal anastomosis (IPAA), which removes the colon and rectum, creates an internal pouch out of a portion of the small intestine, and connects it to the anus for waste removal

While there’s no cure for microscopic colitis, treating it can help you achieve remission.

During remission, your symptoms may lessen or disappear entirely. Doctors define remission as having

However, microscopic colitis symptoms typically return periodically. They sometimes resolve on their own but other times require medication.

Microscopic colitis is a type of IBD that often causes diarrhea and other digestive symptoms.

Treatment typically involves medications to reduce inflammation in the gut and help you enter remission.

Doctors may recommend avoiding foods and drinks that can worsen symptoms, including any that you have an intolerance to.

If symptoms do not improve with medication and lifestyle changes and are intolerable, doctors may recommend surgery for microscopic colitis.

Learn about the potential causes of microscopic colitis.