Microscopic Colitis: Alternative Induction of Remission When Budesonide Is Not an Option

For patients with symptomatic microscopic colitis who cannot receive budesonide, a structured evidence-based approach identifies which alternative therapies support the goal of inducing clinical remission.

Prior Treatment Line

The established first-line induction strategy is budesonide, with a goal of achieving clinical remission within 7–13 days. This protocol is the next step when that approach is not feasible for the patient.

Clinical Goal

The treatment target is induction of clinical remission in patients with symptomatic microscopic colitis for whom budesonide is not a viable option.

Treatment Approach

When budesonide is not feasible, the protocol specifies alternative oral agents for induction — the full regimen, comparative evidence, and clinical considerations are available in the structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1053/j.gastro.2015.11.008

In patients with symptomatic microscopic colitis in whom budesonide therapy is not feasible, the AGA suggests treatment with mesalamine over no treatment for the induction of clinical remission.
In patients with symptomatic microscopic colitis in whom budesonide therapy is not feasible, the AGA suggests treatment with bismuth salicylate over no treatment for the induction of clinical remission.
In patients with symptomatic microscopic colitis in whom budesonide therapy is not feasible, the AGA suggests treatment with prednisolone (or prednisone) over no treatment for the induction of clinical remission.

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