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

被引:142
作者
Fine, KD
Lee, EL
机构
[1] Baylor Univ, Med Ctr, Div Gastrointestinal Res, Dallas, TX 75246 USA
[2] Dallas Vet Affairs Med Ctr, Dept Internal Med, Dallas, TX USA
[3] Dallas Vet Affairs Med Ctr, Dept Pathol, Dallas, TX USA
[4] Univ Texas, SW Med Ctr, Dallas, TX 75230 USA
关键词
D O I
10.1016/S0016-5085(98)70629-8
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
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页码:29 / 36
页数:8
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