In some cases, collagenous colitis disappears on its own. However, some people need treatment.
Your treatment plan will depend on the severity of your symptoms.
Diet and lifestyle changes
Your doctor may recommend diet and lifestyle changes to help treat this condition. These changes are usually the first part of any treatment plan.
Common diet changes include:
Common lifestyle changes include:
Your doctor will review the medications you currently take and make suggestions about either continuing or stopping them.
In 2016, the American Gastroenterological Association (AGA) released its guidelines on microscopic colitis. The AGA recommends starting with budesonide, a type of corticosteroid, before considering other medications.
Other medications your doctor may recommend to help treat the symptoms of collagenous colitis include:
The supplement psyllium may be recommended, too. Immunomodulators or anti-TNF (tumor necrosis factor) therapies may be used in extreme cases.
The Food and Drug Administration (FDA) hasn’t approved any medications for microscopic colitis or collagenous colitis. However, medications such as mesalamine and sulfasalazine are FDA approved for the treatment of ulcerative colitis.
If a doctor prescribes medications such as these for collagenous colitis, it’s considered an example of off-label drug use.
OFF-LABEL DRUG USE
Off-label drug use means a drug that’s approved by the FDA for one purpose is used for a different purpose that hasn’t yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.
Your doctor may recommend surgery if diet and medication changes don’t help. Surgery is usually reserved for extreme cases. It’s not a typical treatment for collagenous colitis.
The most common types of surgery for collagenous colitis include:
- colectomy, which means removing all or part of the colon
- ileostomy, which means creating an opening in the abdomen after a colectomy