Efficacy of open-label bismuth subsalicylate for the treatment of microscopic colitis.

Abstract

BACKGROUND & AIMS:

The pathogenesis of the microscopic colitis syndrome is unknown but may involve bacteria, an intestinal luminal antigen, and/or autoimmunity. It was hypothesized that bismuth subsalicylate would resolve both diarrhea and colonic inflammation in microscopic colitis because it possesses antidiarrheal, antibacterial, and anti-inflammatory properties.

METHODS:

Thirteen patients with microscopic colitis (7 with subepithelial collagen deposition and 6 without) were treated with eight chewable 262-mg bismuth subsalicylate tablets per day for 8 weeks. Patients recorded the frequency of bowel movements daily. Forty-eight-hour stool collections and flexible sigmoidoscopy with 24 biopsies were performed before and after treatment in each patient.

RESULTS:

Twelve patients completed the trial. Eleven patients had a resolution of diarrhea and a reduction in fecal weight. The average time to respond was 2 weeks. In 9 patients, colitis resolved. When present before treatment, subepithelial collagen thickening disappeared. Those completing the trial experienced no side effects. Posttreatment follow-up for 7-28 months shows that 9 patients remain well having undergone no further treatment, 2 are well but required retreatment, and 1 has continued diarrhea.

CONCLUSIONS:

Bismuth subsalicylate treatment for 8 weeks is safe and well tolerated. This regimen appears to be efficacious for the treatment of microscopic colitis and is worthy of further study in a controlled trial.

• Authors: K D Fine, E L Lee
• Journal: Gastroenterology (Gastroenterology) Vol. 114 Issue 1 Pg. 29-36 (Jan 1998) ISSN: 0016-5085 [Print] United States
• PMID: 9428215 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Organometallic Compounds
• Salicylates
• bismuth subsalicylate
• Bismuth

Topics

• Administration, Oral
• Adult
• Aged
• Bismuth (administration & dosage, adverse effects)
• Colitis (drug therapy, pathology, physiopathology)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Organometallic Compounds (administration & dosage, adverse effects)
• Salicylates (administration & dosage, adverse effects)
• Treatment Outcome