Treatment
Summary of Recommendations of the AGA Guideline on the
Medical Management of Microscopic Colitis
Recommendation
Strength of
recommendation
Quality of
evidence
In patients with symptomatic microscopic colitis, the
AGA recommends treatment with budesonide over
no treatment for the induction of clinical remission.
Strong Moderate
In patients with symptomatic microscopic colitis, the
AGA recommends treatment with budesonide over
mesalamine for the induction of clinical remission.
Strong High
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.
Conditional Moderate
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.
Conditional Low
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.
Conditional Very Low
In patients with symptomatic microscopic colitis,
the AGA suggests against combination therapy with
cholestyramine and mesalamine over mesalamine
alone for the induction of clinical remission.
Conditional Low
In patients with symptomatic microscopic colitis,
the AGA suggests against treatment with Boswellia
serrata over no treatment for the induction of clinical
remission.
Conditional Low
In patients with symptomatic microscopic colitis, the
AGA suggests against treatment with probiotics over
no treatment for the induction of clinical remission.
Conditional Low
For patients with recurrence of symptoms following
discontinuation of induction therapy for microscopic
colitis, the AGA recommends budesonide for
maintenance of clinical remission.
Strong Moderate
