What is the treatment for nonspecific colitis (inflammatory bowel disease)?

From the Guidelines

Nonspecific Colitis Treatment

The primary approach for treating nonspecific colitis, also known as inflammatory bowel disease (IBD), is to manage symptoms and reduce inflammation.

• A common initial treatment is with mesalamine, an anti-inflammatory medication, at a dose of 800-1600 mg orally three times a day for 6-8 weeks 1.
• Patients may also be advised to follow a bland diet, stay hydrated, and avoid spicy or high-fiber foods that can exacerbate symptoms.
• In some cases, corticosteroids like prednisone may be prescribed for short-term use to reduce inflammation, typically at a dose of 20-40 mg orally once a day for 2-4 weeks, with a gradual taper 1.
• It's also important to rule out other causes of colitis, such as infectious colitis, and to consider probiotics or fiber supplements for long-term management and prevention of flare-ups.
• For patients who do not respond to initial treatment, infliximab or vedolizumab may be considered as alternative options 1.
• In severe cases, hospitalization may be necessary to manage symptoms and prevent complications, with treatment options including intravenous steroids and other immunosuppressive medications 1.

From the Research

Treatment for Nonspecific Colitis

The treatment for nonspecific colitis, also known as inflammatory bowel disease, can vary depending on the severity and extent of the disease.

• For mild-to-moderate cases, treatment options include:
  • Aminosalicylates, such as mesalamine 2, 3, 4
  • Topical corticosteroids 2
  • Oral corticosteroids for unresponsive cases 2
• For moderate-to-severe cases, treatment options include:
  • Oral or intravenous corticosteroids in the short-term 2
  • Biologic agents, such as tumor necrosis factor-α inhibitors, as initial therapy or in transition from steroids 2, 3
  • Thiopurines, such as azathioprine, as bridging therapy 2, 3, 4
• For severe or fulminant cases, treatment options include:
  • Colectomy, which may be a life-saving procedure 2, 3
  • Early surgical referral is crucial for severe or refractory cases 2
• It's also important to note that patients with nonspecific colitis should continue their follow-up by a specialized ward, as some cases may be underdiagnosed 5

Treatment for Specific Types of Colitis

• For microscopic colitis, treatment options include:
  • Budesonide oral or enema, which is the gold standard 6
  • Bile acid sequestrants, such as cholestyramine, colesevelam, and colestipol 6
  • Biologics, such as infliximab, adalimumab, and vedolizumab 6
• For ulcerative colitis, treatment options include:
  • Mesalamine, which remains the standard treatment for uncomplicated cases 3
  • Glucocorticoids, which are highly effective in the acute treatment but should only be used over the short term due to their marked side effects 3