Lymphocytic Colitis: Causes, Symptoms, and What You Can Do

When you have lymphocytic colitis, a type of microscopic colitis where immune cells build up in the colon lining, causing chronic diarrhea. Also known as lymphocytic inflammation of the colon, it’s not the same as Crohn’s or ulcerative colitis—but it can feel just as disruptive. This condition doesn’t show up on a regular colonoscopy. You need a biopsy to see the extra white blood cells hiding in the colon wall. That’s why so many people go months—or even years—without a diagnosis.

People with lymphocytic colitis, often linked to autoimmune reactions and certain medications. Also known as microscopic colitis, it frequently shows up in adults over 50, especially women. Common triggers include NSAIDs like ibuprofen, proton pump inhibitors (PPIs) for heartburn, and even antidepressants. It’s not caused by infection, but your gut’s immune system goes into overdrive for reasons we don’t fully understand yet. The result? Watery diarrhea that comes and goes, belly cramps, and sometimes urgency so bad you can’t make it to the bathroom in time.

There’s no cure, but most people get better with the right tweaks. Cutting out caffeine, dairy, and high-fat foods often helps. Stopping NSAIDs or switching PPIs under a doctor’s care can make a big difference. Budesonide, a targeted steroid, is the most effective treatment—fewer side effects than older options. And if you’re on meds that might be triggering it, your pharmacist can help you find safer alternatives. It’s not about avoiding food forever—it’s about finding what your body tolerates.

What you’ll find below are real, practical guides on managing symptoms, understanding how medications affect your gut, and avoiding common mistakes that make things worse. From how to track flare-ups with a food and symptom log, to how certain drugs like bismuth subsalicylate (Pepto-Bismol) can help calm inflammation, these posts give you what you need—not just theory, but what works in real life.