Hi Bob,
Welcome aboard. I'm sorry to hear of all your medical issues, and I'm sorry that LC has been added to the mix. Autoimmune diseases tend to run in "packs", so many of the rest of us also have multiple autoimmune issues. As you have found, this can be a very debilitating disease, in itself. Some of us have found that after we control our MC, many/most of our other issues either get better, or disappear altogether. There is a very good chance that the NSAIDs may have contributed to your developing MC, since they are a common trigger for the disease. If you will explore this site, you will find that we have assembled what is arguably the largest database of information related to treating and living with microscopic colitis, in the world, and the built in search function, (not the Google search, but the "Search" link above it), will help you to locate past discussions about virtually any question that you might have.
Basically, noting that no one knows more about this disease than the people who have to live with it every day, we learn by sharing experiences, insight, and research. Obviously, there are many details to be considered, but to answer your question about what you should, (or should not), do, here are some basic guidelines that we have found to be helpful, in achieving remission with this disease. YMMV, of course.
Unfortunately, there is no known cure for MC, (CC, LC, or any of the other known forms of microscopic colitis), but the good news is that the symptoms can definitely be controlled. Bearing in mind that we are all different, and we all respond differently to both meds and diet, there are three basic treatment options.
1. Certain drugs that are capable of suppressing inflammation, (LC
is an inflammatory bowel disease, despite the fact that the American Crohh's and Colitis Foundation chooses to ignore it). The most effective "safe" med, (for the most people), seems to be budesonide, (in the form of Entocort EC, which is an encapsulated form of budesonide, so that it does not become activated until it reaches the ileum and the colon. By passing through the duodenum and jejunum in inactive form, only about 10 to 15% of it is absorbed into the bloodstream, thereby preempting the tendency of most corticosteroids to cause major systemic adverse side effects. It is effective in bring remission for approximately 6o to 70% of members. The 5-ASA meds, such as Asacol, Pentasa, Colazal, Lialda, etc., do not seem to be very effective in bringing remission, though some people have fairly good success using them as maintenance meds, after remission is achieved.
2. Diet control is the safest way to control your symptoms, (since it has no adverse side effects), but finding and eliminating all of your food intolerances from your diet, can be a tedious and frustrating project. Most of us are sensitive to gluten, (the primary protein in wheat, barley, rye, and for some of us, oats), and casein, (the main protein in all dairy products), and about half of us are sensitive to soya, (the main protein in soy beans). Some of us are also sensitive to various other proteins, such as egg whites and corn. Certain foods are irritants to the intestines, even though we may not actually be intolerant of them. Foods in this category include items with significant amounts of fiber, and/or sorbitol, (such as most fruit, and many vegetables), lectins, and/or lecithins, (such as legumes). Artificial sweeteners, especially aspertame, usually cause problems, as do the sugar alcohols, (sorbitol, manitol, etc.). Until you reach remission, and allow sufficient time for your gut to finish healing, never eat any raw fruit or vegetables - especially never eat any raw lettuce. If fruits and vegetables are well-cooked, (overcooked, really), you
might be able to tolerate some of them. For example, most us can tolerate potatoes, well-cooked squash, broccoli, or green beans, in moderation. Be careful when you buy meat, because a lot of it is "injected" with "moisturizing solutions", that may contain gluten, or other intolerances, (such as preservatives). This is especially true of poultry, but a lot of pork is also injected. After your gut has time to heal, you'll be able to add many of these foods back into your diet, (most fruit, vegetables, etc.).
3. A combination of diet and meds is necessary for the most difficult cases. Also, Entocort will allow remission sooner than the diet, alone, so some members use it to help relieve the symptoms, while the diet is helping to heal the gut. After the gut heals, some members are able to discontinue Entocort completely, and maintain remission by diet alone.
If you are interested in trying to control your symptoms by diet, there is a lab in Dallas, TX, known as Enterolab, where you can order test kits, for stool samples, and they can accurately and reliably test for certain food intolerances, in order to simplify the process of deciding which foods are major problems. In general, the skin allergy tests, and blood tests, are pretty much useless for determining the types of food sensitivity that are triggered when LC is triggered.
https://www.enterolab.com/Home.htm
Again, welcome to our group, and please feel free to ask any questions that come to mind. Trust me, we've all been there, done that, and most of us have had "accidents", in some unfortunate locations, so we know what you are dealing with, and how you feel. People who do not have this disease, really have no idea what it's like to have to live with these symptoms, and that especially applies to GI docs. The bottom line is, you
can get your life back, but it's not easy. We're here to help you in any way we can.
Tex (Wayne)
Some GI docs are much more open-minded than others, but our experience has been that a high percentage of them tend to be very stubborn about clinging to "myths" that they picked up somewhere in med school, concerning diet and MC. Hopefully, you will be one of the lucky ones, and your GI doc will be open-minded. Some members have found that the younger GI docs are sometimes more progressive in their understanding of MC.