Microscopic Colitis and high-titer autoantibodies - is this only the beginning?

I've had high ANA (1:1280) and ASMA/Actin Antibody titers (57), plus rheumatoid factor since 2005, when I developed an itchy post-partum rash over 60% of my body. It disappeared after weaning at one year. I never followed up after the rash cleared, went on to have a normal pregnancy 2 years later, and I'm now 2 years post-partum. I recently had 3 months of chronic diarrhea and digestive upset (I have a 10-yr history of mild IBS-D and lactose intolerance), and got a full battery of tests. The only abnormality was microscopic colitis on one of the colonoscopy biopsies. All other tests and antibodies were negative, SED rate was normal, liver and kidney chemistries normal, C-reactive protein normal, no anemia, CBC normal, etc.

Doc wants me to start Asacol but the side effects seem worse than my mild diarrhea. Question is, should I take the anti-inflammatory to try and stop the autoimmune process? The rheumy thinks this could progress to Crohn's, Colitis or autoimmune hepatitis someday.  

I'm thinking about consulting a naturopathic doctor. I've stared fish oil and quercetin (natural anti-inflammatories), but should I accept the Asacol in an attempt to quell the autoantibody activity in my system and prevent a worse disease?

I feel like a ticking time-bomb!

[karajo]

I have lupus and deal with diarrhea everyday.  I take an herb that has been a tremendous blessing.  It's called Slippery Elm.  It coats he entire digestive tract. I take one/daily as a maintance.  But on occasion, the symptoms are overwhelming.  I'll take (2) several times a day for those stubborn flare-ups.  

My heart really goes out to you as I know how this can alter a person's life.  I'm not familiar with the medicine you spoke of.  I've never taken medicine for this condition.  This herb has worked wonderful for me for years.  

You ANA is markedly high.  Did they run a pattern on that?  Do you also have joint pain?  

[TrudieC]

I was diagnosed with ulcerative colitis when I was 21 and 10 years later my bowel perforated.  I fought to live and was lucky I had a wonderful surgeon who removed my entire large colon and put things in place so that I could have an internal pouch done later that would give me back my bowel function.  It is 16 years later and have done so well.

Do try the Naturopath but if you can't get the diarrhea under control soon you may have to go back to the Asacol.  The longer you have active disease the more it can hurt the lining of your bowel and possibly result in what happened with me.  My son now has colitis (much worse than what I had in the early stages) and they put him on Imuran (an immune suppressant) and he has been in complete remission for the last year.  

Pay attention to what is going on and if it gets real bad you must get back to your gastro doc.  They will treat a bad bout with prednisone which really heals it up quickly.  Good luck and I hope you can nip this in the bud before it gets bad.

[Zizle]

Thank you. I'll look into Slippery Elm. I've seen it used for sore throats.  My ANA pattern is speckled.