It is suggested that patients refractory to the above therapies should be treated with a short course of oral steroids. Most patients will have a positive response to therapy but the relapse rate is high. Pardi et al reported retrospective analyses of all patients treated at the Mayo clinic for…
Bile acid binding agents: Use of agents that bind bile acids was reviewed in the pathogenesis section of the present paper. In short, a recent study by Ung et al found that 44% of patients with CC had abnormal bile acid absorption and that open-labelled cholestyramine (4 g per day)…
A randomized, double-blind, placebo-controlled multicentre trial was published in October 2002 by Miehlke et al. Fifty-one patients with CC were randomly assigned to receive either budesonide (9 mg/day) or placebo for six weeks. The clinical remission in the budesonide group was 86.9% compared with 13.6% in the placebo group. Histological…
Antidiarrheals: Nonspecific antidiarrheal therapy has been commonly used in the management of MC yet no published prospective or randomized studies were identified. Results of the two largest retrospective studies are included in Table 2. Due to the relative safety of these agents and the possibility of spontaneous remission, many suggest…
Numerous agents have been used in the treatment of MC from no therapy to high dose immune modulatory therapy. Unfortunately, most treatment approaches are based on very little significant clinical data. Thus, most physicians have adopted treating the individual patient in a stepwise approach, paying close attention to the potential…
The natural history of MC is not clear. The mean duration of symptoms before diagnosis in one study was two months for LC and four months for CC but these figures vary greatly. The clinical course is variable. Generally, symptoms are mild and spontaneous remissions can occur. One group reported…
A more recent study reported that the diagnostic yield was highest from biopsies of the transverse colon (83%) and right colon (70%) and lowest from the rectosigmoid colon (66%). In one large study, normal rectal biopsies were found in 43% of patients with CC and 8% of patients with LC….