Lately one of my patients told me about microscopic colitis (in here case lymphocytic colitis) being diagnosed. As she had been on sulfasalazine, she asked me, if it would harm her. My first though was that sulfasalazine could be a good idea since there are hints that the lymphocytic colitis has a immunologic background. There is an association with NSAIDs and some antidepressants, however. And my patient took NSAIDs.
There is only one publication from 2006 addressing the issue (1). M. Fekih and colleagues published: [Microscopic colitis. A 20 cases series] Original article in French. The authors reported 20 cases. “Endoscopic examination was normal in 95% of patients. We diagnosed collagenous colitis in 65% of cases and lymphocytic colitis in 35% of cases.” They observed a clinical remission in 41.2% of 16 patients. An interesting observation, but since it hasn’t been followed in the past 10 years, sulfasalazine shouldn’t be considered a therapeutic option in lymphocytic colitis.