Hi Bob,
Those observations came from various references, which stated "generally accepted" opinions of the issues surrounding MC. In the quote you included from Dr. Fine's site, for example, note that he said:
. . .any form of colitis is the result of the body's immune system setting up an unusual attack on the bacteria living in the colon. What makes the body suddenly recognize these bacteria as harmful and worthy of this attack is not fully understood . . .
He doesn't actually say that the body's immune system attacks the "good" bacteria, nor does he say that it attacks the "bad" bacteria. He implys that all bacteria are involved, and equally targeted. (Though an imbalance of "good" versus "bad" bacteria may, of course, be a possible trigger that initiates this event). Also, note that Dr. Fine has a habit, (like many of us who have websites), of never removing, and never editing, material from his site. Instead, as he discovers new evidence that creates new insights and opinions, he adds new articles to the site. The older articles, however, are left intact. At least that appears to be the case, as far as I can tell.
As I mentioned previously, no one knows for sure exactly what causes MC, and there are many theories about it. Personally, I believe that there may be many immediate causes, but ultimately, I lean toward the opinion that the reactions themselves are caused by an immune system response against a virus that feels threatened, and the virus attacks what it perceives as an attack on itself, whether it be by NSAIDs, various other meds, the two toxic gliadins in gluten, or various other toxins, (or perceived toxins), such as lectins, for example. The virus feels that it is being attacked, so it begins to replicate itself, and the immune system of the patient senses the virus reproducing in large numbers, and launches an immue response against it. That's how I see it.
Here's what the Crohn's and Colitis Foundation of America says about MC:
What Causes Microscopic Colitis, and Who Gets It?
What's responsible for the damaged lining of the colon in microscopic colitis? As with ulcerative colitis and Crohn's disease, the exact cause has yet to be identified. But bacteria, bacterial toxins, and viruses are among the usual suspects that have been implicated.
Some experts have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, might be the actual culprits. It is also possible that these medications might simply aggravate symptoms in individuals who are already prone to the syndrome. Another theory is that collagenous colitis and lymphocytic colitis are caused by an autoimmune response, which means that the body launches an attack upon itself -- mistaking various cells in the colon for foreign intruders. The final answer may well turn out to be some combination of these theories.
They also suggest a connection between MC and celiac sprue, which I strongly agree with. Here's a link to the article on their website, if you want to read the rest of the story.
http://www.ccfa.org/about/news/microscopiccolitis
The Pepto Bismol treatment was the first practical treatment for MC that was developed, (and it was develped by Dr. Fine, of course), however, he no longer recommends it, primarily because without additional changes in the patients lifestyle, such as diet restrictions, the symptoms almost always return a few weeks after the bismuth treatment is discontinued, and there is a slight risk of toxic reactions to the bismuth.
The PB treatment can only be used for about 8 weeks, because of the accumulation of bismuth in the body, which will eventually reach toxic levels, and cause serious problems. In fact, some of our members had toxic reactions after only a few weeks, and some had problems after only a few days of treatment with PB. Anyway, this is why the PB treatment has fallen out of favor, and Dr. Fine's current recommended treatment of choice, is diet.
Dr. Fine has always recommened a probiotic, but curiously, to my knowlege, he has never found one that he feels fully satisfies the needs of most MC patients, so he cannot recommend one to use. Initially, he recommended Culturelle, but he stopped recommending it after he apparently had problems with it himself. (In case you are not aware of this, Dr. Fine himself, has MC, which I'm sure is a driving force behind all the research that he has done in this area).
Tex
