Microscopic Colitis Treatment in Manchester

In the two main types of irritable bowel disease (Crohn’s and Ulcerative Colitis) the damage to the gut lining is on such a scale that it can be seen when a colonoscopy or an endoscopy is carried out. These large-scale changes are macroscopic, however as the name suggests, the damage found in Microscopic colitis is small, microscopic. Microscoptic colitis is most commonly seen in women over the age of 60. While it may not be associated with a reduction in life expectancy but as with other digestive issues quality of life can be drastically reduced. Chronic watery diarrhoea is the most common symptom and occurs in 7.5% of this group. It is not uncommon to experience up to 15 bowel movements a day. Other symptoms include bloating and pain, nausea, fatigue and weight loss. You’re more likely to develop Microscopic colitis is you have a history / family history of autoimmunity, particularly coeliac disease. Habitual smoking and regular use of a range of medication which include NSAIDs, PPIs (ie omeprazole), beta blockers, or statins are also risks. Changes in the bacteria in the gut also seem to play a role especially. It’s been seen that beneficial anti-inflammatory species of bacteria are reduced and levels of pro-inflammatory bacteria increase. This can preceed the onset of symptoms.

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Microscopic Colitis Testing

Complete stool testing is vital to assess and infections such as cryptosporidium, and giardia. C. difficile toxins, salmonella and shigella are also important to assess for. Stool testing also provides information of how well you are (or may not be) producing digestive enzymes which can also impact gut function. Evaluation of thyroid health and coeliac disease are also helpful as are complete blood counts. Ruling out SIBO (small intestinal bacteria overgrowth) can also be helpful in certain cases. This is to assess the bacterial load in the small bowel as elevated numbers here can also contribute to chronic diarrhea.

A note about testing

I aim to keep testing as affordable as possible. While some of these tests may be requested via your GP others can only be ordered through private laboratories. Part of the initial consultation is set aside to discuss the pro, cons and costs associated with the various tests I feel would be the most helpful.


A number of diets are recommended which are suggested on a case by case basis. The aim of these is to assess for food sensitivities, assess triggers and well as to reduce inflammation.


IBS is an overarching umbrella term that describes someone’s symptoms.  Within this, there are 3 subtypes of IBS.  IBS with diarrhoea, IBS with constipation and IBS with a mix between the 2.

Even though these subtypes give a clearer indication of someone’s symptoms, they go no further to inform us what the underlying issue is.

The SIBO tests measure 2 types of gas, hydrogen, and methane.  If there are elevations in 1 of these gases, we can name that Hydrogen or Methane SIBO.  It’s also possible to have elevations in both gases.

The type of gas that is elevated helps to guide supplement protocols to target the specific organisms that produce that type of gas.

A third type of gas, hydrogen sulfide, can also be produced by the gut bacteria. However, it is not currently possible to test for this gas.

Generally speaking, there are 3 components to a supplement protocol to address the elevated bacteria in SIBO.  These can include a combination of probiotics, prebiotics, and antimicrobial herbs.

Depending on the underlying issue (eg. the reasons why the bacteria are there in the first place) additional supplements may be suggested.

SIBO is a bacterial overgrowth in the small intestine with several underlying causes.  The majority of those with SIBO can have the small intestine rebalance, however, there are also some who either have treatment-resistant or chronic SIBO.

This largely depends on the underlying cause.  Particularly, if parts of the small intestine have been damaged, this may lead to reoccurring SIBO.

This SIBO test may be offered through the NHS, however, it’s not uncommon for the waiting time for this test to be several months.

By ordering directly from the laboratory, we are able to have the test sent to your home within 3-5 days. The results will be back 7-10 days after the laboratory has received the samples.



From your first consultation, you will receive a supplement protocol.  I like to describe supplements as a form of scaffolding.  If a building is in need of support, we erect scaffolding.  The digestive system is no different.

The aim is not to be taking lots of supplements forever but to use them in the short term to support, repair and rebalance.

The duration of a supplement protocol will vary on your symptoms, the underlying imbalance and any additional factors that may be contributing to your digestive issues.

Generally speaking, 8 weeks is an average time to be on a specific supplement protocol.  Following this, a maintenance protocol may be recommended.

The supplements I recommend vary depending on your specific situation and set of symptoms.  Common recommendations include probiotics, specific herbal extracts to help rebalance and modify the gut bacteria as well as beneficial, gut-friendly prebiotics.

Following your consultations, you will receive a link to an online ‘shopping basket’ with the products I recommend.  These are generally delivered within 24-48 hours.



I am not a doctor and can therefore not officially diagnose your condition.

However, as with the diagnosis of IBS, labels may not always be helpful.  By digging deeper and identify underlying imbalances we can often bring symptoms under control.

It is also important that your GP is kept up to date with any findings.  If appropriate, and with your approval, I may write to your GP to request further investigations or assessments.

I am a fully insured registered Nutritional Therapist with membership through BANT and CNHC, the main governing bodies within the UK.

I am also continuously engaged in current research as well as additional educational courses as a form of continuing professional development (CPD).



The initial consultation is 90 minutes long.  Here we talk about your symptoms in depth, how and when they started, other contributing factors as well as your current diet.

From this consultation, you will receive your protocol.  This will include detailed dietary suggestions, a supplement protocol, recommendations for further testing as well as appropriate lifestyle recommendations.

From this point, it’s beneficial to speak every 3-4 weeks to assess progress and make any adjustments to your protocol.

To make sure this is the right approach for you, please book a free 15-minute consultation with me here.

Without knowing more about your specific symptoms this is a hard question to answer.

However, generally speaking, the majority of those that I work with typically feel 3 consultations, over a 2-month period is all that is required.

I appreciate that it can be frustrating when you’re looking for a quick resolution of symptoms.  As with many other health conditions, healing is not always a straightforward path.

There are several dietary templates that often offer symptom relief over a matter of days.  While these are not long-term approaches, they can be a way to help ease symptoms and help you feel more comfortable as the underlying issues are identified and addressed.