Visit the Microscopic Colitis Foundation Website
Harma found this article, (the authors are Dutch), and brought it to my attention. I find it very interesting - first, because it is quite recent, (February, 2009), and second, because it confirms some very important points about treatment, that we have long held to be true, even though most GI docs dispute them. Also, it raises an interesting observation about Dr. Fine's Pepto-Bismol treatment, (though they failed to give him credit for doing the study they discussed, and for developing the treatment).
The confirmation of treatment details that I'm referring to, are in regard to the fact that budesonide is presently the only viable choice for treatment of MC, (in their opinion, if drugs are to be used). We have long held that it's by far the best choice, even though many GI docs initially prescribe all sorts of anti-diarrheals, anti-inflammatories, bile sequestrants, and various other types of drugs, which list constipation as a side effect, hoping that they will work.
This article also points out that budesonide will not cure MC, it will only control the symptoms if treatment is maintained indefinitely. (This is also something that we have long-maintained to be true, despite contrary medical opinion from the majority of GI docs). Not surprisingly, (to us, at least), the author's case studies showed that relapses almost always occur, if the drug is discontinued. Soooooooooo, we finally have some medical opinion that concurs with what we have been claiming, all along.The other observation that I thought was very, very interesting, is their experience in using bismuth subcitrate, to successfully bring remission in cases where budesonide was not successful. Not only that, but it appears that in the cases they cited, remission continued indefinitely, after treatment was completed, without any form of maintenance medication, (and presumably without any diet modification, since they never mentioned any diet changes in the article). We may have to reexamine the use of Pepto-Bismol, again, since the bismuth subsalicylate used in Pepto, is very similar to the bismuth subcitrate that they used.
The main problem with the article, of course, is the fact that the authors seem totally oblivious of the fact that diet changes should be considered as the first treatment option,
but at least they are right on target with their descriptions of treatment methods using medications. 
Also, I have long maintained that MC can be easily missed by sigmoidoscopies, (IOW, colonoscopies should always be used to diagnose MC), unless the GI doc understands what he is seeing on the monitor screen, and therefore knows how to pinpoint the sites where biopsy samples should be taken, for maximum effectiveness. Most have no idea what to look for. I see that the authors agree with me.
http://www.njmonline.nl/njm/getpdf.php?t=a&id=10000416Performing a sigmoidoscopy with biopsies alone would lead to a missed diagnosis in 40% of cases.7,11
That's a PDF version. If you would prefer an HTML version:
http://74.125.95.132/search?q=cache:yTk ... +Wouden1,3*
Thanks Harma, for finding a very enlightening article, and bringing it to our attention.
Tex
