Using Mesalamine to Treat Crohn's Disease - Benefits and Effectiveness

Using Mesalamine to Treat Crohn's Disease

Crohn's disease is a type of inflammatory bowel disease that causes inflammation and irritation in the digestive tract. This chronic condition can lead to abdominal pain, diarrhea, fatigue, weight loss and malnutrition. While there is no known cure for Crohn's disease, various medications can help control symptoms and bring about remission.

One medication that is sometimes used to treat Crohn's disease is mesalamine. Mesalamine is an anti-inflammatory drug that can help reduce inflammation in the intestines and relieve symptoms of Crohn's disease. Here is an in-depth look at using mesalamine to treat Crohn's disease.

What is Mesalamine?

Mesalamine, also known as 5-aminosalicylic acid (5-ASA), is a medication that is used to treat inflammatory bowel diseases like Crohn's disease and ulcerative colitis. It helps to reduce inflammation in the digestive tract and can induce remission in people with mild to moderate Crohn's disease.

Mesalamine is thought to work by adhering to epithelial cells in the intestines. This helps it act locally on areas of intestinal inflammation. The drug helps regulate the production of certain chemicals that promote inflammation, including cytokines, prostaglandins and leukotrienes.

Mesalamine comes in both oral and rectal formulations. Common brand names for oral mesalamine include Asacol, Lialda and Apriso. Rectal formulations include Canasa suppositories and Rowasa enemas.

Using Mesalamine for Crohn's Disease Treatment

Mesalamine may be used to treat mild to moderate Crohn's disease affecting the colon. It helps to reduce inflammation in the intestines, which in turn alleviates symptoms of Crohn's disease like diarrhea, rectal bleeding and abdominal cramps.

Taking mesalamine orally allows the drug to spread through the intestines and reach inflamed areas. People with Crohn's colitis or inflammation in the colon are often prescribed oral mesalamine. The delayed-release tablets are usually taken two to four times per day and the extended-release tablets are taken once daily.

Using mesalamine rectally as an enema or suppository can help deliver the medication directly to inflamed areas in the lower colon and rectum. This method may be used for people with inflammation in those regions of the intestines.

Mesalamine treatment is considered effective if it helps induce remission of mild to moderate Crohn's disease symptoms. Taking this anti-inflammatory medication long-term may help keep the disease in remission and prevent flare ups.

Benefits of Using Mesalamine for Crohn's

There are several potential benefits of using mesalamine to treat Crohn's disease:

• Helps reduce intestinal inflammation
• Alleviates symptoms like diarrhea and abdominal pain
• Well-tolerated with mild side effects
• Comes in oral and rectal formulations
• May help achieve remission in mild disease
• Allows tapering or discontinuation of steroids
• Can be used for long-term maintenance
• Lower cost than biologic medications

Compared to other medications used for Crohn's, mesalamine is relatively well-tolerated. Most people experience only mild side effects like headache, nausea or diarrhea.

Mesalamine is also less expensive than biologic drugs that are sometimes prescribed for moderate to severe Crohn's disease. Since treatment often needs to be taken long-term, the lower price point makes mesalamine a more accessible option for many patients.

Potential Side Effects

While mesalamine is generally well-tolerated, some possible side effects may occur. Potential side effects associated with mesalamine include:

• Headache
• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Rash
• Hair loss

In rare cases, mesalamine use can cause kidney problems or blood disorders. Patients taking this medication should have regular checkups and blood work to monitor for side effects.

People with known allergies to salicylates like aspirin should avoid mesalamine, as they may have an allergic reaction. Seek medical attention for any signs of hypersensitivity such as rash, itching, swelling or difficulty breathing.

When is Mesalamine Ineffective?

While mesalamine can help some people with mild Crohn's disease, it is not effective for everyone. This medication may not work well in the following situations:

• Severe inflammation or strictures in intestines
• Fistulas or abscesses present
• Small intestine (non-colonic) disease
• Previous lack of response to mesalamine
• High risk for poor medication adherence
• Need for rapid symptom control

People with more severe Crohn's disease often need stronger medications like corticosteroids, immunomodulators or biologics. Mesalamine is not potent enough on its own to treat high levels of inflammation.

Other anti-inflammatory drugs like corticosteroids may be quicker acting for people who need rapid relief. Mesalamine can take weeks or months to reach its full effect.

Complementary Crohn's Treatments

While mesalamine can help control inflammation in Crohn's disease, it does not treat the underlying cause. Many people use this medication in conjunction with other therapies to best manage their Crohn's symptoms.

Some complementary treatment options include:

• Immunomodulators - Drugs like azathioprine, 6-mercaptopurine and methotrexate that modify the immune system to reduce inflammation.
• Biologics - Injectable monoclonal antibodies like infliximab, adalimumab, certolizumab and others that target inflammatory proteins.
• Corticosteroids - Oral or IV drugs like prednisone that non-selectively suppress inflammation.
• Liquid diets - Consuming nutrition shakes and low fiber foods helps rest the intestines.
• Surgery - People with severe small intestinal disease may need resection surgery to remove damaged areas.
• Mental health treatment - Therapy, mindfulness and support groups help manage the stress of chronic illness.

Using two or more approaches together gives people with Crohn's disease the best chance at achieving remission and an improved quality of life.

Who Should Not Take Mesalamine?

While mesalamine can be effective for some people with Crohn's disease, it is not appropriate for everyone. You should avoid mesalamine if:

• You have a known allergy or hypersensitivity to mesalamine, salicylates or sulfasalazine.
• You have severe kidney impairment.
• You have ulcerative colitis, as it may worsen diarrhea.
• You are taking azathioprine or 6-mercaptopurine.

Make sure to tell your doctor about any medical conditions you have and medications you are taking to avoid potentially dangerous interactions.

Mesalamine should also be used cautiously in older adults, as they are more likely to experience side effects like kidney problems. Children may be more sensitive to possible blood disorders caused by mesalamine.

The Takeaway

Mesalamine is an anti-inflammatory medication that can be helpful for reducing inflammation and achieving remission in people with mild to moderate Crohn's disease affecting the colon. It comes in both oral and rectal formulations.

Potential benefits of mesalamine include reduced intestinal inflammation, ability to taper steroids, and relatively mild side effects. However, mesalamine may not work for people with more severe disease or those who need rapid symptom relief.

Mesalamine is often used with other therapies like immunomodulators, biologics and diet modification as part of a comprehensive Crohn's disease treatment plan. Work closely with your doctor to determine if mesalamine could be an effective part of your Crohns treatment.

Frequently Asked Questions

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.