Microscopic Colitis

What do I need to know about microscopic colitis?

I thought some of you may be interested in Dr. Fine's study on microscopic
colitis and the newsletter that comes out about once a week. This is the
latest newsletter.

Report from Dr. Fine on the relationship of microscopic colitis to celiac
sprue

About 2000 years ago a famous physician named Aretaeus living in a country
called Cappadocia (now in present-day Turkey) made some strikingly accurate
observations. As documented in his translated writings, he noticed there
were pale emaciated individuals that for no obvious reason experienced
heavy pains of the stomach, and diarrhea, consisting of undigested food in
a fluid state. Aretaeus called this syndrome "The Coeliac Affection." Today
we know it similarly as celiac disease or celiac sprue.

Although not known 2000 years ago, we now know that the small intestinal
disease, celiac sprue, is caused by a dietary protein called gluten derived
from wheat, barley, rye, and oats. If this disorder is not recognized and
properly treated, patients experience chronic diarrhea, weight loss, bone
mineral loss, malnutrition, anemia from vitamin/iron deficiencies, and
muscle emaciation. It is treated by a rigorous diet that eliminates the
grains containing gluten from the diet.

In a research study conducted and reported last year, we discovered that
microscopic colitis was responsible for most cases of chronic diarrhea
after patients with celiac sprue were diagnosed and treated (published in
the journal Gastroenterology June1997, volume 112, pages 1830-1838). This
year we have discovered why this is so. It turns out that the same gene
that predisposes to celiac sprue also predisposes to the development of the
microscopic colitis syndrome (both the collagenous and lymphocytic types).
This means that patients with sprue can get microscopic colitis (which we
already knew) but also that patients with microscopic colitis can get
celiac sprue. However, the gluten sensitivity in colitis patients may not
display classic features but instead may be so mild that it cannot even be
diagnosed by current methods. We are working on a more "molecular" method
to diagnose occult gluten sensitivity.

It is my opinion that everyone with microscopic colitis should have the
blood tests looking for celiac sprue/gluten sensitivity, especially if your
colitis has been difficult to treat or if you have had early relapses after
successful treatment with Pepto Bismol or another agent. There are three
blood tests: Antigliadin antibodies of two types: IgG and IgA, and
antiendomysial antibody (IgA). I will relate more details as they develop.

Our next treatment study (hopefully to be started in 1-2 months) has had
built into the protocol tests to insure that patients with microscopic
colitis do not have celiac sprue also.

Dr. Fine has also agreed to experiment with a question & answer section to
appear in this newsletter. Send any short question, no more than 50 words,
one per person. Be sure to note at the beginning the question is intended
for "Ask Dr. Fine."

Ask Dr. Fine:

[Carol Taylor asked how to recognize severe dehydration & how to take
calcium supplements when they seem to set off colitis attacks.]

The main symptoms of dehydration are thirst, darkening and decreased flow
rate of urine, fast heart rate, and dizziness or a faint feeling when you
stand up from sitting or lying. The latter symptom in particular is a sign
that it is becoming severe.

I am unaware of "colitis attacks" being set off by calcium, but any
supplement or medicine can cause a particular side effect in an individual.
In general, calcium seems to be constipating. Pepto Bismol tablets contain
alot of calcium and they have been proven to help colitis.

I am still on asacol & 2 wks. ago I started on pepto-bismol. It has slowed
down the big D, but has not went into remission yet.The dr. is sending me
to a neptrologist. He thinks maybe the medicine is damaging my kidneys.
Just wondering if anyone else has this problem. Please let me hear from you
if this is happening to you. Take care & remember god loves you.

[I'm assuming it's the Asacol he's worried about. Let us know if you find
out what's going on.....Judy]

Hi Everyone from Nancy in New York. Just want to tell anyone who is having
trouble with a chapped butt that Desitin cream for babies butts works
wonderfully! It contains Zinc Oxide that works to seal, and heal your sore
butts. I am doing pretty well, still on the asacol, one two times a day,
with some diaherria on a reoccuring basis with no warning but seems to pass
the next day with only some gas problems for twenty four hours. Carol in
Burlington N.J. is looking to communicate with someone on Asacol, I am your
gal. On it for almost three years, and I also take acidophillus from a
health food store which helps me a lot! Carol you can reach me at
nwris...@hotmail.com I will try to answer as quickly as possible. Wishing
Everyone a Blessed Christmas and a Healthy New Year. Bye for now.

I'm Grete Cooper (33) from Norway. For the last six years I've lived/worked
in Cairo, Egypt. With so many members of the CCClub and so many newsletters
I'll spare you the details as my history is similar to many others. After
d. for seven years (possibly triggered by dysentery in India in 1989/90) I
was diagnosed with CC in September 1997. Asacol had no effect and I have
not tried any other medicine. Like many others I also have headaches,
stomach cramps, pain in my shoulders, neck and back, etc. I have two
questions:

1. Approximately 40 % of patients with CC/LC/MC are accompanied by
ANA-positive arthritis. After having read the newsletters my impression is
that most of us have aches and pains ("Arthritis light"), but not many seem
to get severe, disabling, arthritis. For those of you who have had CC/LC/MC
for many years (10 years +) I would like to know if the aches and pains in
neck, shoulders, back etc. seem to get gradually worse over the years or if
it stays much the same?

2. Has anybody made a list (in alfabetical order?) of the different
medicines/treatments the members of the club have suggested and/or tried?

I believe keeping fit helps a lot - both physically and mentally. It also
makes you able to run to the bathroom faster!