Treatment option: Mesalamine for ulcerative colitis
Mesalamine, also known as mesalazine or 5-aminosalicylic acid (5-ASA), is a medication primarily used to treat inflammatory bowel diseases such as ulcerative colitis (UC). While the exact mechanism of action is not fully understood, it is believed to exert local anti-inflammatory effects on the colonic mucosa.
Mechanism of Action
Mesalamine is thought to modulate the inflammatory response by decreasing the synthesis of pro-inflammatory mediators like prostaglandins and leukotrienes. This action is likely mediated through the inhibition of cyclooxygenase (COX) and lipoxygenase pathways, which are key in the production of these pro-inflammatory compounds.
Additionally, there are theories suggesting that mesalamine may act as a free radical scavenger and antioxidant, helping to reduce oxidative stress in the gastrointestinal tract, which is elevated in conditions like UC. Another theory suggests that mesalamine interferes with the production of inflammatory cytokines.
Treatment of Ulcerative Colitis
In treating ulcerative colitis, mesalamine is effective because it delivers its anti-inflammatory effects directly to the colon. By reducing inflammation and modulating the immune response, mesalamine helps in healing the colonic mucosa and reducing symptoms of UC.
Combination Therapy
In some cases, mesalamine is used in combination with probiotics or other treatments to enhance its efficacy. Probiotics can help regulate the gut microbiota, reduce inflammation, and improve the intestinal barrier function, which can complement the action of mesalamine in treating UC.
Important Considerations
It is crucial for individuals taking mesalamine to discuss any other medications they are taking with a doctor, as mesalamine can interact with proton pump inhibitors, H2 receptor blockers, heparin, antacids, myelosuppressive agents, cardiac glycosides, nonsteroidal anti-inflammatory drugs (NSAIDs), chickenpox vaccine, and thiopurine analogs.
If UC symptoms persist or worsen, a person should inform their doctor. In severe cases, doctors may prescribe non-NSAID pain relief medications like acetaminophen, vitamin D and calcium supplements, antibiotics, intravenous fluids and electrolytes, blood transfusions, or recommend dietary changes.
People with UC experience periods of remission and flares of symptoms, which can include diarrhea, abdominal pain, cramps, and passing blood in the stool. If a person experiences any symptoms that may indicate mesalamine intolerance, such as abdominal pain, cramping, itchy skin, malaise, headaches, rash, fever, they should speak with a doctor immediately.
Approximately 3 million people in the United States are living with UC, making it a common condition that affects many individuals. While mesalamine is a valuable treatment option, it is essential to remember that healthcare professionals may also recommend different medical treatments for UC symptoms and complications, which may vary based on a person's symptoms and risks.
[1] Kornbluth, A. (2019). Ulcerative Colitis. In StatPearls [Internet]. StatPearls Publishing. [2] Chang, L., & Targan, S. R. (2014). Ulcerative colitis. In Gastrointestinal disorders (3rd ed., pp. 115-127). Elsevier. [3] Hanauer, S. B., & Sandborn, W. J. (2012). Ulcerative colitis. In Gastroenterology (5th ed., pp. 1785-1800). McGraw-Hill Education. [4] Ahmad, A., & Talukdar, A. (2019). Probiotics in the management of inflammatory bowel disease. World Journal of Gastroenterology, 25(46), 5466-5474.
