Medical Management of Microscopic Colitis
Based on guidelines from the American Gastroenterological Association.
Treatment
Treatment: Symptomatic Microscopic Colitis
The AGA recommends treatment with budesonide over no treatment for the induction of clinical remission.
Strong recommendation
Moderate quality evidence
The AGA recommends treatment with budesonide over mesalamine for the induction of clinical remission.
Strong recommendation
High quality evidence
In patients in whom budesonide therapy is not feasible, the AGA suggests treatment with bismuth salicylate over no treatment for the induction of clinical remission.
Conditional recommendation
Low quality evidence
In patients in whom budesonide therapy is not feasible, the AGA suggests treatment with prednisolone (or prednisone) over no treatment for the induction of clinical remission.
Conditional recommendation
Very low quality evidence
In patients in whom budesonide therapy is not feasible, the AGA suggests treatment with mesalamine over no treatment for the induction of clinical remission.
Conditional recommendation
Moderate quality evidence
The AGA suggests against combination therapy with cholestyramine and mesalamine over mesalamine alone for the induction of clinical remission.
Conditional recommendation
Low quality evidence
The AGA suggests against treatment with Boswellia serrata over no treatment for the induction of clinical remission.
Conditional recommendation
Low quality evidence
The AGA suggests against treatment with probiotics over no treatment for the induction of clinical remission.
Conditional recommendation
Low quality evidence
Treatment: Recurrent Symptoms
For patients with recurrence of symptoms following discontinuation of induction therapy for microscopic colitis, the AGA recommends budesonide for maintenance of clinical remission.
Strong recommendation
Moderate quality evidence
What do the icons mean?
How strong is the AGA's recommendation?
Strong recommendation
Most individuals in this situation would want the recommended course of action, and only a small proportion would not.Conditional recommendation
The majority of individuals in this situation would want the suggested course of action, but many would not.High quality evidence
We are very confident that the true effect lies close to that of the estimate of the effect.Moderate quality evidence
We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.Low quality evidence
Our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect.Very low quality evidence
We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect.
