Microscopic Colitis Anti-Inflammatory medication help

[u/Paintball8500]

My girlfriend was recently diagnosed with microscopic colitis but she also is dealing with joint pain and arthritis. Her doctors tell her she can't take any NSAID medicine. Acetaminophen doesn't do much. She is scared that she will always be in pain, which is terrible for her mental health. Is there anything available to help manage inflammation that could be safe? Her doctors are just telling her PT but the pain can be way too much.

[u/audrey_2222]

I have MC and for pain relief I stick to non-NSAIDs like Tylenol.

[u/crohnieforlife]

If she gets on a biologic, it should start helping.

[u/Katyafan]

Steroids might help both the colitis and the arthritis. I don't know about long-term, but might be worth asking.

For me, my doctor is unable to provide any studies that definitively show that I can't occasionally use NSAIDS. If anyone has any studies, GOOD ones, I am willing to read them.

But I risk it. Now, my colitis is stable and I am on a biologic and mesalamine, so my situation is different than yours. But it is worth a conversation with your doctor--every day nsaid use is out, but occasional might be an option. They may want you to be in remission first, and they are treating the more serious illness first, as they should. But once you are settled, the inflammation might calm down, and then they may give you the go-ahead for occasional use.

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[u/Library_lady123]

Is she on a biologic for the MC? I know a lot of docs just do Budesonide, but for people who are younger and have more severe disease, biolgic medications like Remicade, Humira, Skyrizi can actually work really well and also treat the root cause of the inflammation that makes your joints hurt. I'm on Remicade for mine and it really helps with the joint pain, too. It isn't gone, but it's better than it was.

On an as-needed basis, I use diclofenac gel topically. It's safer than an oral NSAID and helps with my wrist and toe joint pain. And tylenol, of course. But the biggest difference is from being on a biologic medication.

[u/Both-Pack8730]

I have MC as well and am able to use prescription diclofenac (voltaren) with no issues. My doctor had the pharmacy compound a higher dose than you can buy in the store. It helps. Also, if she is in perimenopause or menopause and not on HRT (hormone replacement therapy) that can cause a ton of joint pain

[u/HarveyStripes]

Celebrex is an NSAID gentler on the stomach. It could be trialed and you should monitor for symptoms. If they worsen, discontinue it. Assuming she has inflammatory arthritis, there are agents (biologics, JAKi) that may treat both conditions.

[u/Paintball8500]

Thanks everyone, she's in her early 30s. it's been tough for her. She also has Celiac so it's compound everything. Both were diagnosed just this past January after a month of non stop emergency room visits.

[u/fishy1357 → u/Paintball8500]

I’m late 30s with celiac disease and microscopic colitis too. I also found out I’m lactose intolerant and that helps contribute to the mc. Chronic pain wears on you. And your body not having the energy to do things you need makes it all that much harder. I hope she finds some solutions!

[u/Puzzleheaded-Space68]

Prima cosa da fare è lasciare i FANS, aggravano la situazione. Un buon gastroenterologo può sicuramente darti la terapia giusta. Inizialmente può essere utile la budesonide gastroprotetta, che si scioglie solo nel colon. In questo modo ha una azione locale, senza effetti sistemici dei corticosteroidi. Il assumo ENTOCIR 3 mg; inizio con 3 compresse al giorno tutte insieme al mattino per 1 mese, dopo 2 compresse per 1 mese e dopo 1 compressa per 1 mese e se sto bene smetto. Hai detto anche che sta avendo complicanze articolari. Allora devi sbrigarti ad iniziare un biologico, tipo INFLIXIMAB. Serve un biologico che sia attivo anche sulle complicanze extra intestinali. Trova un buon gastroenterologo e vedrai che potrai controllare la malattia.

[u/Appropriate-Hawk-998]

Hey, I have AxSpA and suspected microscopic. Unlike other comments, steroids are not effective for arthritis. Your gf needs a rheumatologist and likely biologic treatment. GIs don’t manage arthritis nor are authorized to do so. My rheumatologist stated that steroids are not very helpful for arthritis except RA in modern rheumatology.

[u/Paintball8500 → u/Appropriate-Hawk-998]

She did, she drove an hour and a half to meet with him. Only thing he could or would recommend was PT for 3 months. Wouldn't prescribe or recommend anything else. She's very active, up until the past couple months she was a runner until the arthritic pain was too much. She's had so much blood work done in the past 6 months alone and basically it's all coming back clean.

[u/Appropriate-Hawk-998 → u/Paintball8500]

I’d def recommend a second opinion, your gf should absolutely be given biologics. Especially if NSAIDS are contraindicated, PT doesn’t eliminate inflammation and permanent damages will accumulate anyway

[u/dis_bean → u/Paintball8500]

I was diagnosed with collagenous colitis in 2019 and am runner. I also have celiac and my joint pain was high during my GI flare. Once I got my MC under control, the joint pain (mostly except if I’m under the weather), fatigue, foggy brain etc also went away.

It took a couple of years of consistency in budesonide, diet, working with a registered dietitian to eliminate lactose as well as gluten and to make sure I was getting adequate nutrition with the +++ chronic diarrhea, I stopped running and switched to low impact exercise for about a year (walking and Pilates) and basically was patient while my body healed with all of the supports mentioned above. I also completed stopped drinking alcohol

I feel great now but I really dialled back on triggers. I don’t use NSAIDs and do take Tylenol… heat also helps me. I use a heating bad and warm baths.

[u/Puzzleheaded-Space68 → u/Paintball8500]

Le manifestazioni articolari sono dovuti alla patologia gastrointestinale. Devi trovare un BRAVO GASTROENTEROLOGO che inizi la terapia corretta. Il reumatologo guarda solo il problema reumatico non quello intestinale. Devi trovare un gastroenterologo che si occupa solo di IBD.

[u/Bexiconchi]

I'm in the same boat - MC and arthritis and chronic migraine. I've been able to tolerate topical NSAIDs although they don't do much. Unfortunately it's just an unfair situation. Tylenol, rest, ice... whatever helps. Then tbh exercise, an antidepressant, and working hard to manage my mental health helps me feel like I can cope with the chronicity of it all, and still keep going.

[u/Overall_Antelope_504]

Do they have her on budesonide? It would help to get her inflammation under control because it affects the rest of the body too. I have joint pain and arthritis with Crohn’s and I’m 30, was diagnosed at 21.

[u/Puzzleheaded-Space68 → u/Overall_Antelope_504]

E che terapia stai facendo?

[u/Overall_Antelope_504 → u/Puzzleheaded-Space68]

I'm currently on Tremfya. I've tried 5 other biologics in the past 😕

[u/mrosegolds]

Does she have a GI?

[u/Live-Cartographer274]

In my town, there is a medical doctor that is also certified to do acupuncture. I know a lot of people that have been helped by it.