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Guideline

Medical management of microscopic colitis

A guide to selecting treatments for patients with microscopic colitis.

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Recommendations

1. In patients with symptomatic microscopic colitis, AGA recommends treatment with budesonide over no treatment for the induction of clinical remission.

2. In patients with symptomatic microscopic colitis, AGA recommends treatment with budesonide over mesalamine for the induction of clinical remission.

3. In patients with symptomatic microscopic colitis in whom budesonide therapy is not feasible, AGA suggests treatment with mesalamine over no treatment for the induction of clinical remission.

4. In patients with symptomatic microscopic colitis in whom budesonide therapy is not feasible, AGA suggests treatment with bismuth salicylate over no treatment for the induction of clinical remission.

5. In patients with symptomatic microscopic colitis in whom budesonide therapy is not feasible, AGA suggests treatment with prednisolone (or prednisone) over no treatment for the induction of clinical remission.

6. In patients with symptomatic microscopic colitis, AGA suggests against combination therapy with cholestyramine and mesalamine over mesalamine alone for the induction of clinical remission.

7. In patients with symptomatic microscopic colitis, AGA suggests against treatment with Boswellia serrata over no treatment for the induction of clinical remission.

8. In patients with symptomatic microscopic colitis, AGA suggests against treatment with probiotics over no treatment for the induction of clinical remission.

9. In patients with recurrence of symptoms following discontinuation of induction therapy for microscopic colitis, AGA recommends budesonide for maintenance of clinical remission.

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