Doctors at Johns Hopkins are leading the way in research for treating collagenous and lymphocytic colitis. We believe in staying active in current studies to further our understanding of these diseases. Through our continuous efforts to offer the latest treatment strategies, our gastroenterologists continue to provide excellent patient care. Many patients choose to be part of our patient registry, which helps us gather information and learn how to take care of our patients even better in the future.
Collagenous and Lymphocytic Colitis Treatment: Medication
Research on collagenous and lymphocytic colitis treatment suggests that a medication regimen may be helpful in relieving symptoms. Anti-inflammatory medication appears to improve diarrhea in patients. Because research on this condition is limited, doctors are not sure of the danger of leaving collagenous and lymphocytic colitis untreated.
Treatment options include:
Symptomatic treatment aims to improve symptoms, but does not address the underlying cause of the condition. Symptomatic treatment includes:
Eliminating caffeine or foods containing lactose, as those foods may aggravate diarrhea
Maintaining a low-fat diet, especially if steatorrhea (excess fat in stool) is present
Taking cholestyramine, a medication that reduces cholesterol levels in the blood
Taking antidiarrheal medications
Investigators have treated patients with collagenous colitis using antibacterial medication. In a trial of 12 patients, 11 reported that their diarrhea disappeared and did not recur, even two years after treatment.
Sulfasalazine is a medication that reduces inflammation. A low dose will be prescribed and gradually increased it until you achieve full dosage. Slowly increasing the dosage avoids such side effects as nausea and headaches. Fifty percent of patients responded to this therapy; within one to two weeks, the diarrhea noticeably lessened. You may need to be on the full medication for three months, and then your doctor will gradually lower the dosage.
If sulfasalazine failed to improve your symptoms after two to four weeks, or you were unable to tolerate it well, adrenocorticoids may be prescribed. Adrenocorticoid medication is a steroid treatment that can resolve diarrhea in as quickly as five days.
Patients who have more than two liters of stool per day may need to be hospitalized and treated with intravenous steroids. Once diarrhea is under control, you will need to continue taking the medication for at least three months. Your doctor will discuss treatment options if your diarrhea recurs after you discontinue the medication.
Other courses of treatment include taking over-the-counter medication that provides relief for upset stomach and diarrhea.
In severe cases, surgeons need to perform an ileostomy, a surgical procedure that brings the end of the small intestine outside of the body. Waste passes out of the ileostomy and is collected in an external pouch attached to the skin.
Many of these treatment approaches are effective in resolving the symptoms of collagenous and lymphocytic colitis. However, there are few patients who are completely cured of the disease. Research is continuing into the most appropriate length of therapy.