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    Suggest treatment for microscopic colitis

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Posted on Mon, 31 Jul 2017 in Digestion and Bowels
Question: I have microscopic colitis. I have been trying to watch my diet & have just finished 7 weeks of taking pepto-bismol. My weight loss has slowed & I am better, but I am still losing weight 1/2 lb. every few weeks. What is my next step. I do not want to go on steroids.
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Answered by Dr. Ramesh Kumar 2 hours later
Brief Answer:
Life style modification is the main stay of treatment.

Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic.

Have gone through your details.
Answers are as follow-

Microscopic colitis is an inflammation of the large intestine (colon) that causes persistent watery diarrhea. Initial step in controlling the problem is life style and diet modification-
Avoid beverages that are high in sugar or sorbitol or contain alcohol or caffeine, such as coffee, tea and colas, which may aggravate your symptoms. Choose soft, easy-to-digest foods. These include applesauce, bananas, melons and rice. Avoid high-fiber foods such as beans and nuts, and eat only well-cooked vegetables.A simple and natural diet is excellent.This should consist of unrefined food such as whole grain cereals, XXXXXXX honey and lentils; green leafy vegetables, like spinach, beans, lettuce, celery, asparagus, carrot.Intestinal flora are types of microorganisms known as probiotics that live normally as part of the intestinal tract. These organisms have several functions that help the body.The most plentiful and important bacteria in the small intestine is the Lactobacillus species. Lactobacillus helps ferment indigestible carbohydrates. It also helps to stimulate the digestive process and aid the absorption of nutrients,as well as increase the motility of the gastro intestinal tract.I would suggest her to start taking probiotics regularly.Probiotics are live bacteria and yeasts that are good for digestion. and would indirectly help you in dealing woth intestinal inflammation.
Fruits and vegetables, which contain high amounts of fiber, aid in alleviating symptoms ,Whole-grain bread, XXXXXXX oatmeal, beans and lentils can also relieve the problem so use it Instead of highly processed rice, eat brown rice, millet or bulgur.Eat 2 cups of fruit 3 cups of vegetables and about 35 grams of fiber per day.
fruits: Generally all fruits, except XXXXXXX fruit, are beneficial.
Pears,Guava and grapes would be good for you.

Step 2 would be to taper you off pepto bismol and to maintain you on life style maintainance only.Initially lower the doses of pepto to half after a week start taking it on alternate day.The doses would be tappered slowly as per the response of your body.

Do you have loose stools?
Do you have pain in abdomen?

Please mention your symptoms.

Waiting.
Thanks!



Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ramesh Kumar 2 hours later
Thank you for your reply, I am taking a probiotic- trunature digestive probiotic, 10 billion active cultures. If you recommend another one, I would like to hear about it. I am also lactose intolerant, so I have to take that into account in all my meals & meds. You asked about my stools. Most times my stools are soft & formed going every few days while on the pepto. If I happen to have a dessert tho in eating out with friends or at our church I often have 1-2 diarrhea stools several hours later. Then may lose 1/2 lb. a day or two later and cannot regain the weight. This is getting very frustrating for me. Do you have some suggestions? I would appreciate your help. Thank you
doctor
Answered by Dr. Ramesh Kumar 6 hours later
Brief Answer:
Follow up.

Detailed Answer:
Hi again,
As you are already on dietary restrictions for loose stool problems you can use following medications as and when required.
Dicyclomine is an anticholinergic drug.An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the neurotransmitter acetylcholine to its receptor in nerve cells.They reduces the frequency if stools.So whenever you feel like having increased stool frequency you can have it thrice daily 10 mg.

Clidinium bromide is an anticholinergic (specifically a muscarinic antagonist) drug. It may help symptoms of frequent stools and is usually very effective.

Even if nit helped by them you can take imodium as and when required it will stop stools.

All three of them are very safe and can be used by you on as and when required basis.


For weight gain i would suggest you to start taking protein supplements daily.
Hydrolysed proteins can be taken safely in lactose intolerants also.This will help you to gain lean mass.


Thanks!

Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2436 Questions

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