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Amaro, Rafael; Poniecka, Anna W.; Rogers, Arvey I.

doi:10.1023/a:1005584810298

Cited by 26 publications

(4 citation statements)

References 10 publications

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“…Therapy was noted to be more effective in patients with milder symptoms and older patients. There has also been a case report of lower dose bismuth sub-salicylate, two tablets of 262 mg each, three times daily for 1 month, resulting in clinical and histologic remission 61. While there have not been any adverse events related to bismuth salicylate treatment and the cost of therapy is relatively low, there is potential for neurotoxicity and nephrotoxicity with long-term use, and the significant pill burden is a conceivable barrier to compliance with therapy 62…”

Section: Refractory MCmentioning

confidence: 99%

<p>Management of microscopic colitis: challenges and solutions</p>

Shor¹,

Churrango²,

Hosseini³

et al. 2019

CEG

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Microscopic colitis (MC) is a chronic inflammatory bowel disease characterized by nonbloody diarrhea in the setting of normal appearing colonic mucosa. MC has two main subtypes based on histopathologic features, collagenous colitis and lymphocytic colitis. Management of both subtypes is the same, with treatment goal of reducing the number of bowel movements and improving consistency. First-line treatment involves counseling the patient about decreasing their risk factors, like discontinuing smoking and avoiding medications with suspected association such as NSAIDs, proton pump inhibitor, ranitidine, and sertraline. Starting loperamide for immediate symptomatic relief is used as an adjunct to therapy with glucocorticoids. Budesonide is considered first-line treatment for MC given its favorable side effect profile and good efficacy, though relapse rates are high. Systemic glucocorticoids should be reserved to patients unable to take budesonide. In glucocorticoid refractory disease, medications that have been tried include cholestyramine, bismuth salicylate, antibiotics, probiotics, aminosalicylates, immunomodulators, and anti-tumor necrosis factor-alpha inhibitors. More research is needed for the creation of a systematic stepwise approach for relapsing and refractory disease.

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Section: Refractory MCmentioning

confidence: 99%

<p>Management of microscopic colitis: challenges and solutions</p>

Shor¹,

Churrango²,

Hosseini³

et al. 2019

CEG

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“…They found decreased diarrhea severity that was dose-related: higher doses (up to nine tablets daily) were more effective than lower ones, which was also observed in all demonstrative cases (Vignette 1, Vignette 2, and Vignette 3). In all of the MC and bismuth studies reviewed, bismuth reduced diarrhea in MC patients, 5,16,33,35 which was also seen in the case of Vignette 1.…”

Section: Microscopic Colitismentioning

confidence: 80%

“…The resolution of inflammation at the histological level by bismuth was also seen in a case study involving collagenous colitis. 35 Gentile et al 16 studied both collagenous and lymphocytic colitis October 15, 2020  Epub ahead of print patients who were treated with bismuth. They found decreased diarrhea severity that was dose-related: higher doses (up to nine tablets daily) were more effective than lower ones, which was also observed in all demonstrative cases (Vignette 1, Vignette 2, and Vignette 3).…”

Section: Microscopic Colitismentioning

confidence: 99%

Is There a Role for Bismuth in Diarrhea Management?

Senderovich

Vierhout

2021

Rambam Maimonides Med J

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Diarrhea, an illness of both the developed and developing world, involves the burdensome characteristics of frequent bowel movements, loose stools, and abdominal discomfort. Diarrhea is a long-standing challenge in palliative care and can have a myriad of causes, making symptomatic treatment pertinent when illness evaluation is ongoing, when there is no definitive treatment approach, or when effective treatment cannot be attained. Symptomatic therapy is a common approach in palliative care settings. Bismuth is a suitable agent for symptomatic therapy and can be effectively employed for management of chronic diarrhea. The objective of this narrative review is to examine the role of bismuth in management of diarrheal symptoms. To explore this, PubMed (including Medline) and Embase were used to search the existing literature on bismuth and diarrhea published from 1980 to 2019. It was found that bismuth has potential utility for diarrheal relief in multiple settings, including microscopic colitis, traveler's diarrhea, gastrointestinal infection, cancer, and chemotherapy. It also has great potential for use in palliative care patients, due to its minimal side effects. Overall, the antisecretory, anti-inflammatory, and antibacterial properties of bismuth make it a suitable therapy for symptomatic treatment of diarrhea. The limited range of adverse side effects makes it an appealing option for patients with numerous comorbidities. Healthcare providers can explore Bismuth in Diarrhea Management Rambam Maimonides Med J | www.rmmj.org.il 2 October 15, 2020  Epub ahead of print bismuth as an adjunct therapy for diarrhea management in an array of conditions, especially in the palliative care setting.

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“… 65 Studies suggest that bismuth subsalicylate may also be used as a treatment. 66 In a small study of 12 patients treated with eight tablets of bismuth subsalicylate daily for 8 weeks, 92% had a symptomatic response within 2 weeks and 75% had complete resolution of their symptoms. 67 However, patients should be advised that stools may turn a darker color with bismuth.…”

Section: Diagnosismentioning

confidence: 99%

Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis

Gentile

Yen

2018

Gut and Liver

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Microscopic colitis (MC), which is comprised of lymphocytic colitis and collagenous colitis, is a clinicopathological diagnosis that is commonly encountered in clinical practice during the evaluation and management of chronic diarrhea. With an incidence approaching the incidence of inflammatory bowel disease, physician awareness is necessary, as diagnostic delays result in a poor quality of life and increased health care costs. The physician faces multiple challenges in the diagnosis and management of MC, as these patients frequently relapse after successful treatment. This review article outlines the risk factors associated with MC, the clinical presentation, diagnosis and histologic findings, as well as a proposed treatment algorithm. Prospective studies are required to better understand the natural history and to develop validated histologic endpoints that may be used as end points in future clinical trials and serve to guide patient management.

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Untitled

Cited by 26 publications

References 10 publications

<p>Management of microscopic colitis: challenges and solutions</p>

<p>Management of microscopic colitis: challenges and solutions</p>

Is There a Role for Bismuth in Diarrhea Management?

Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis

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