Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website http://www.gastrores.org

Original Article

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


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

Tables

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)-
Type-
  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.
58208
29Budesonide724% (7/29)3
18Budesonide91Insurance/change brand91Non-compliance/budesonide9
Budesonide91Wean off/5-ASA--
Budesonide91Maintenance/5-ASA2,4001Failure/budesonide6
Budesonide919 → 3 taper failure/5-ASA2,4001Failure/prednisone?
8Budesonide619 → 3 taper failure/ 5-ASA4,500--
Budesonide61Mild symptoms/diphenoxylate/atropine2.5/0.025 TID--
3Budesonide31ND/loperamide4--
135-ASA538% (5/13)3
45-ASA1,2001Failure/prednisone401Side effects/budesonide6
35-ASA1,6001Failure/budesonide9 → 61Remissio/5-ASA2,400
45-ASA2,4001Flare/prednisone101Osteoporosis/5-ASA2,400
15-ASA4,8001Failure/budesonide9--
15-ASA4,8001Bloating/5-ASA---
5Diphenoxylate/atropine2.5/0.025480% (4/5)
1Diphenoxylate/atropineBID1Failure/budesonide9--
1Diphenoxylate/atropineTID1Failure/5-ASA1,200--
1Diphenoxylate/atropineQID1Failure/hyocyamine0.3751Failure/budesonide9
2Diphenoxylate/atropineND15-ASAND--
3Bismuth subsalicylate262133% (1/3)
1Bismuth subsalicylateBID1Budesonide6--
1Bismuth subsalicylateTID-----
1Bismuth subsalicylateQID-----
3Antibiotics266% (2/3)
1Metronidazole500 TID1Liprofloxacin500 BID--
2Metronidazole + ciprofloxacin500 TID/500 BID1Loperamide4 PRN--
2Hyocyamine
2Hyocyamine0.125 QID-----
1CholestyramineND-----
1Prednisone10/taper-----
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