Budesonide Is Effective in Treating Lymphocytic Colitis: A Randomized Double-Blind Placebo-Controlled Study

Miehlke, Stephan; Madisch, Ahmed; Karimi, Diana; Wonschik, Susann; Kuhlisch, Eberhard; Beckmann, R; Morgner, Andrea; Müeller, Ralph; Greinwald, Roland; Seitz, Gerhard; Baretton, Gustavo; Stolte, Manfred

doi:10.1053/j.gastro.2009.02.078

Cited by 152 publications

(110 citation statements)

References 28 publications

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“…The same efficacy of budesonide at the dose of 9 mg/ day has been demonstrated in the treatment of LC by two placebo-controlled studies conducted in 2009 by Miehlke et al 21 and Pardi et al 22 Both studies also showed substantial improvement in colon inflammation. 21,22 Two other randomized placebo-controlled trials conducted by Bonderup et al 23 and Miehlke et al 24 showed that clinical remission and histological response could be maintained in most patients with budesonide at a dose of 6 mg/day for 6 months, with an 83% response rate.…”

Section: Histological Diagnosismentioning

confidence: 61%

Microscopic colitis: A literature review

Clara

Magnago

Ferreira

et al. 2016

Rev. Assoc. Med. Bras.

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Microscopic colitis (MC) refers to chronic inflammation of the colon which is characterized by histologic changes at the level of a radiologically and endoscopically normal mucosa. It is a common cause of chronic non-bloody diarrhea that occurs primarily in older individuals; however, there are few studies in the literature with strong scientific evidence compared to other inflammatory bowel diseases (IBD), which limits the knowledge of physicians and pathologists. This article aims to review the information on MC, describing diagnostic methods and drugs available for treatment. We conducted a search of the Pubmed database and CAPES Portal using the keywords "microscopic colitis", "collagenous colitis", "lymphocytic colitis", and "review" for selection of articles published between 1996 and 2015 related to the topic. Based on the studies discussed in this review, we conclude that MC is a relatively new gastrointestinal disorder, most studies are incipient particularly with respect to pathophysiology and immunology, and budesonide is the best documented short-term treatment. However, further studies are needed to elucidate the best strategy for treatment in the long term.

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Section: Histological Diagnosismentioning

confidence: 61%

Microscopic colitis: A literature review

Clara

Magnago

Ferreira

et al. 2016

Rev. Assoc. Med. Bras.

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“…Medical therapy is generally successful, and budesonide is the best-documented treatment for LC. 13,14 It is the drug of choice for patients unresponsive to antidiarrheal drugs and other medical regimens. 13,14 In this case, the diagnosis of LC was made at a later stage, and budesonide was prescribed by the out-patient department.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 It is the drug of choice for patients unresponsive to antidiarrheal drugs and other medical regimens. 13,14 In this case, the diagnosis of LC was made at a later stage, and budesonide was prescribed by the out-patient department. We presume two possibilities concerning the evolution of the disease: first, both disease entities could have occurred simultaneously, or there was a subsequent manifestation of MRSA enterocolitis following the overuse of antibiotics, with initially quiescent underlying LC.…”

Section: Discussionmentioning

confidence: 99%

A Case of Methicillin-Resistant Staphylococcal Enterocolitis with Subsequent Development of Lymphocytic Colitis

Bae¹,

Han²,

Park³

et al. 2011

Intest Res

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Staphylococcus aureus (S. aureus) is occasionally a normal inhabitant of the gastrointestinal tract, and rarely considered a cause of enterocolitis. Methicillin-resistant Staphylococcal enterocolitis may cause persistent diarrhea leading to severe complications and even death, without appropriate treatment. Lymphocytic colitis (LC), a subtype of microscopic colitis, is a relatively common cause of chronic watery diarrhea. We report the case of a 73-year-old woman with profuse watery diarrhea caused by methicillin-resistant S. aureus. Soon after treatment of her enterocolitis with vancomycin the patient's general condition and symptoms improved, although the diarrhea persisted. Through colonoscopic biopsy and immunohistochemical staining, overt LC was diagnosed, and prompt therapy with budesonide was initiated. (Intest Res 2011;9:139-143)

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“…Budesonide is the only drug which has been proved to be efficient by randomized, placebo-controlled trials, and it is to date the standard treatment for moderate to severe MC [Münch et al 2012;Storr, 2013]. Budesonide therapy resulted in a significant improvement in both clinical symptoms and histological inflammatory changes, but the relapse frequency is about 61-80% [Baert et al 2002;Bonderup et al 2003;Bonderup et al 2009;Mielke et al 2005;Miehlke et al 2009]. The relapse frequency is reduced by sustained treatment at low dosage [Stewart et al 2011].…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

New insights and challenges in microscopic colitis

Ohlsson

2014

Therap Adv Gastroenterol

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Microscopic colitis (MC) is described as an inflammatory bowel disease characterized by chronic, bloodless diarrhea with normal or close to normal endoscopic findings. Histopathological examination reveals two subtypes: collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically. The disease debuts typically in middle-aged patients, but can occur at all ages, including children. A female predominance is found in both CC and LC, but is not confirmed by others in LC. The etiology is unclear, but the disease has been assumed to be of autoimmune origin. However, several etiologies may render a microscopic inflammation in the mucosa; this is a common, universal reaction to a variety of irritants in contact with the intestinal lumen. Furthermore, some patients with a microscopic inflammation in their colonic mucosa have no symptoms, or are suffering from constipation or abdominal pain, rather than diarrhea. Recently, a discussion was initiated calling into question the overdiagnosing of symptoms and pointing out the danger of exacerbating people's perception of their ailments, of weakening their eligibility in health insurance, of overprescription of drugs, and thus the increasing cost to the society of health care. In the light of this discussion, this review will highlight histopathological and clinical features of MC, and discuss the diagnosis and management of this disease. Perhaps, the intestinal mucosa has no other mode by which to react than an inflammatory response, irrespective of the presence or absence of autoimmunity. Thus, to better identify and classify subgroups of MC, and to clarify and correctly handle the inflammatory changes, this field of research stands to benefit from a review of the results and experience gained to date.

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Budesonide Is Effective in Treating Lymphocytic Colitis: A Randomized Double-Blind Placebo-Controlled Study

Cited by 152 publications

References 28 publications

Microscopic colitis: A literature review

Microscopic colitis: A literature review

A Case of Methicillin-Resistant Staphylococcal Enterocolitis with Subsequent Development of Lymphocytic Colitis

New insights and challenges in microscopic colitis

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