Microscopic colitis is an inflammatory disorder of the colon or the large intestine that leads to watery diarrhea & cramps. It is a type of inflammatory bowel disease. It is called microscopic because the inflammation can only be seen under a microscope as it is too small to be seen with the naked eye.
There are 2 types in microscopic colitis, lymphocytic & collagenous colitis. In patients with lymphocytic colitis, there is an increase in lymphocytes or white blood cells in the epithelium while in collagenous colitis the layer of collagen under the epithelium grows thicker.
The symptoms of watery diarrhea, abdominal cramps, nausea & fecal incontinence can be hard to manage or deal with in day to day life for a patient of microscopic colitis. It is a condition that is hard to manage, & in some people even with the use of medications the symptoms cannot be relieved. The diet plays an important role in these people where most people have shown relief in symptoms after changing dietary habits.
Which Fruits Are Good For Microscopic Colitis?
The foods that should be included in your diet when you have microscopic colitis are apples, bananas, melons & rice. It is also important to take small meals throughout the day, rather than one large meal. It can cause more bouts of diarrhea. In addition to this taking drinks with electrolytes also help. Keeping yourself hydrated with broth & diluted fruit juices all help the body function better. A multivitamin & mineral rich diet is also useful for people with chronic diarrhea & nutrient malabsorption. Daily intake of good quality probiotic is also recommended to strengthen the gut flora.
The foods that irritate the gut should be avoided in microscopic colitis, such as beverages containing caffeine, spicy foods (that can irritate the digestive tract) & foods that are high in lactose or fiber content. Foods that contain high amount of fiber such as beans, raw vegetables, nuts, breads, pastas, starch bases foods, dairy products such as milk & cheese, & foods made with artificial sweeteners might worsen your symptoms. Foods that are particularly spicy, fried & fatty upset the digestive tract even more. Limitation of coffee, tea, soda & alcohol is also advised. In general a person is advised to keep track of what foods aggravate the symptoms, so that the cause of indigestion can be identified.
Can Your Diet Affect Microscopic Colitis?
Sometimes microscopic colitis gets better on its own & other times it does not. When the symptoms do not improve or continue to worsen then your doctor might advise you to make some dietary changes before proceeding onto the medical treatments.
Certain ingredients such as caffeine, artificial sweeteners, lactose & gluten may irritate the colon & cause diarrhea. In addition to eating a healthy diet it is also important to stay hydrated as well by consuming loads of fluids. It helps in replenishment of your stores & helps food pass through the digestive tract more efficiently.
Medical Management Of Microscopic Colitis
The treatment of microscopic colitis includes the use of antidiarrhea agents such as loperamide (imodium), diphenoxylate & atropine (lomotil). The other drugs used are bismuth subsalicylate (pepto-Bismol), budenoside (Entocort EC), 5-ASA (mesalamine) compounds such as Asacol, Pentasa, or Colazal.
Controlled trials have shown budenoside to be effective in controlling diarrhea in more than 75% of the patients with collagenous colitis. The only disadvantage is that the diarrhea tends to recur soon after stopping budenoside.
In some cases use of azathioprine & 6-mercaptopurine have been shown to suppress the immune system where other medications have failed to show response. However the use of NSAIDs should be prevented that may lead to microscopic colitis. Lactose elimination can be tried in case where milk might aggravate the diarrhea.
If changing your diet or discontinuing medications does not help in relieving of symptoms then other treatment options include drugs to block bile acids & prevent diarrhea, & sometimes surgery to remove a portion of the colon.
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