Here is the code to add a table and columns. I haven't modified table but it should be possible.
'-- set reference to ADOX library
'- Microsoft ADO Ext. 2.6 for DDL and Security
'-- Microsoft ActiveX data objects 2.6 library also needed for ADO
Dim cg As New Catalog
Dim tb As New ADOX.Table
Dim cn As ADODB.Connection
Set cn = CurrentProject.Connection
tb.Name = "Test"
tb.Columns.Append "col1", adInteger
tb.Columns.Append "col2", adVarWChar, 50
cg.Tables.Append tb
You can check the reference to see if it allows change. After putting code in Access right click on Columns and pick definition. This allows you to look at available functions/properties. Check under Column, it has a name property. You may be able to update.