Microscopic colitis is an inflammation of the bowel lining that doctors can only see under a microscope. Treating this condition with medication is often possible, but dietary and lifestyle changes may also help reduce or prevent symptoms.

Microscopic colitis (MC) causes recurrent episodes of chronic, watery, non-bloody diarrhea for at least 4 weeks. Other symptoms of this condition can include:

In some people, the condition may resolve without treatment. The cause of MC is still not clear.

This article considers whether dietary changes can help treat MC and explores other lifestyle changes and medical treatments.

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Researchers are currently studying the possible connection between diet and MC.

So far, there is little evidence to suggest a link between what people eat and the symptoms of MC. Researchers in Sweden published a study in 2016 that followed 135 people with MC over 22 years and monitored their intake of the following:

The researchers could not find an association between these dietary components and MC.

Learn about foods that can reduce inflammation in the colon.

There are currently no dietary guidelines for people with MC. However, despite limited research into the topic, there is some interest in using probiotics.

Probiotics

Some researchers have suggested that probiotics may benefit people with MC because these bacteria and yeasts can help relieve symptoms of other gut conditions, such as irritable bowel syndrome (IBS) and ulcerative colitis.

However, there is only limited evidence that probiotics or other foods that increase beneficial gut bacteria may help treat MC. More research into probiotics is necessary to confirm their effectiveness for people with this condition.

Always talk with a doctor before trying probiotics.

Learn more about probiotic foods here.

Water

Drinking plenty of water or other liquids during episodes of MC is essential. The body loses fluids during episodes of diarrhea, which can lead to dehydration. Drinking enough water is also essential for many bodily functions, including digestive processes.

Learn more about the benefits of drinking water here.

Certain foods and drinks may irritate the bowel and worsen or trigger symptoms in people with MC. In particular, some people may find it beneficial to avoid caffeine, lactose, and high fat foods.

A doctor or dietitian can also recommend a diet plan to suit an individual’s needs based on their symptoms. For example, if a person has fatty or oily stools, a doctor may recommend a low fat diet.

Keeping a food diary can help people identify foods that trigger or worsen their symptoms.

People may need to stick to an elimination diet for several weeks before they notice any improvement in their symptoms. The following foods may exacerbate MC symptoms, such as diarrhea.

Caffeine

Foods and drinks that contain caffeine can include:

Learn more about the effects of caffeine on the body here.

Lactose

Foods and drinks that contain lactose can include:

  • milk, buttermilk, and cream
  • yogurt
  • cottage cheese, cream cheese, and sour cream
  • soft cheeses
  • ice-cream

Learn about lactose intolerance here.

Fiber

Doctors may recommend a low fiber diet to help manage diarrhea for people with MC. Fiber aids the passage of food through the digestive symptom. In some people, a low fiber diet may relieve diarrhea symptoms during an episode of MC.

Foods that are high in fiber include:

  • beans, pulses, and peas
  • nuts and seeds
  • potatoes
  • raw fruits
  • raw vegetables, such as broccoli, cauliflower, and spinach
  • whole wheat or whole grain bread, cereals, pasta, and rice

Speaking with a doctor or dietitian before adopting a low fiber diet is best. They can provide advice on which foods to avoid.

Learn more about a low fiber diet here.

Gluten

In people with celiac disease and non-celiac gluten intolerance, eating foods containing gluten causes digestive symptoms similar to those of MC, including diarrhea and abdominal pain. People with celiac disease are more likely to have MC than people without this condition.

A person with MC should see their doctor for a blood test to rule out celiac disease. There is no cure for celiac disease, but a gluten-free diet will help minimize or prevent symptoms.

Gluten is a general name for the naturally present proteins in cereal grains, such as wheat, rye, and barley. People with celiac disease should avoid foods that contain gluten.

Learn about the foods that contain gluten, gluten intolerance, and gluten sensitivity here.

FODMAPs

FODMAPs are certain carbohydrates (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) that the body has difficulty digesting. They can also cause digestive symptoms. People on a low-FODMAP diet avoid foods containing these carbohydrates. Foods that contain these carbohydrates include:

  • fruits and vegetables
  • dairy products
  • wheat and rye products
  • sugars and artificial sweeteners

Although there is little research on MC specifically, a low FODMAP diet can help relieve symptoms in people with other digestive disorders, such as IBS.

Speak to a doctor or dietitian before trying a low FODMAP diet.

Learn more about the low FODMAP diet here.

Researchers believe excessive alcohol consumption might increase the risk of developing MC. Some people with MC may find that avoiding or limiting alcohol consumption improves their symptoms.

Smoking can increase the risk of developing or worsening symptoms of many digestive disorders, including MC. Doctors usually advise people with MC who smoke to quit.

There is not yet any scientific proof that medications can cause MC. However, there are links between MC and certain medications, including some antidepressants, several cardiovascular drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen.

A doctor can provide information on which medications may worsen or trigger symptoms of MC. It is essential to speak to a doctor before stopping any prescription medications.

Learn about drug interactions here.

Medications are generally effective in treating MC. In addition to recommending dietary and lifestyle changes, a doctor or gastroenterologist may prescribe:

  • medications that reduce or prevent diarrhea
  • corticosteroids, such as budesonide
  • antibiotics
  • immunomodulators and anti-TNF therapies

Learn about treatments for ulcerative colitis here.

There is only limited research on which foods may help or worsen MC. Keeping a food diary can help a person identify and avoid foods that seem to trigger symptoms. People should avoid foods containing substances they are intolerant to, such as lactose or gluten.

Drinking plenty of water during episodes of diarrhea is essential to prevent dehydration. People with MC may also benefit from reducing their caffeine intake and adapting their diet. Quitting smoking and avoiding alcohol may also help.

If medications or dietary and lifestyle changes are not helping, it is best to speak to a doctor.

Read the article in Spanish.