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Mesalamine

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

By mouth

Mesalamine is used to treat and prevent ulcerative colitis (an inflammatory bowel disease). It works inside the intestine (bowel) to reduce inflammation… Read more

Brand names include: Apriso, Asacol 800

Into the rectum

Mesalamine is used to treat an inflammatory bowel disease, such as ulcerative colitis. Mesalamine suppositories are used to treat mild to moderate active… Read more

Brand names include: Canasa, Mesasal

Drug classes About this
Anti-Inflammatory, Gastrointestinal Agent

What works? Research summarized

Evidence reviews

A meta-analysis of balsalazide, mesalazine and sulphasalazine in the treatment of active ulcerative colitis

Bibliographic details: Zhang Z F, Duan Z J, Zhao G, Liu L N, Wang Y D.  A meta-analysis of balsalazide, mesalazine and sulphasalazine in the treatment of active ulcerative colitis. World Chinese Journal of Digestology 2008; 16(30): 3464-3468

Efficacy and safety of mesalazine versus sulfasalazine for ulcerative colitits: a systematic review

Bibliographic details: Liu RM, Wu B, Zhao YJ, Tang Y.  Efficacy and safety of mesalazine versus sulfasalazine for ulcerative colitits: a systematic review. Chinese Journal of Evidence-Based Medicine 2011; 11(2): 181-186 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=201102012

Treatments for lymphocytic colitis

Budesonide is a corticosteroid drug that is quickly metabolized by the liver thereby decreasing drug‐related side‐effects. This review demonstrates that budesonide may be effective for treating chronic diarrhea associated with lymphocytic colitis over a six week period. There is also weaker evidence that mesalazine with or without cholestyramine may be effective for treating chronic diarrhea associated with lymphocytic colitis over a six month period. These and other agents require further study before they can be recommended as treatment options for lymphocytic colitis.

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Summaries for consumers

Treatments for lymphocytic colitis

Budesonide is a corticosteroid drug that is quickly metabolized by the liver thereby decreasing drug‐related side‐effects. This review demonstrates that budesonide may be effective for treating chronic diarrhea associated with lymphocytic colitis over a six week period. There is also weaker evidence that mesalazine with or without cholestyramine may be effective for treating chronic diarrhea associated with lymphocytic colitis over a six month period. These and other agents require further study before they can be recommended as treatment options for lymphocytic colitis.

Curcumin for maintenance of remission in ulcerative colitis

Curcumin is a natural anti‐inflammatory agent that is often used in many chronic inflammatory conditions including rheumatoid arthritis, esophagitis and post‐surgical inflammation. The purpose of this systematic review was to examine the effectiveness and safety of curcumin therapy for the maintenance of remission in patients with ulcerative colitis (UC), a chronic inflammatory condition of the colon. Currently available agents for the management of this condition have been reported to result side effects, particularly when used for prolonged periods. This review includes one randomized trial with a total of 89 participants. All patients received treatment with sulfasalazine or mesalamine (drugs containing 5‐aminosalicylic acid). Fewer patients in the curcumin group relapsed at six months compared to patients who received placebo (e.g. fake drug). However, this result was not statistically significant. Patients in the curcumin group had significantly lower disease activity index and endoscopic index scores at six months than patients in the placebo group. No serious side effects were reported. A total of nine mild side effects were reported in seven patients. These side effects included a sensation of abdominal bulging, nausea, a brief increase in blood pressure, and a brief increase in the number of stools. The results of this systematic review suggest that curcumin may be a safe and effective therapy for maintenance of remission in ulcerative colitis when given as additional therapy with mesalamine or sulfasalazine. Further research is needed to confirm any possible benefit of curcumin for maintenance therapy in ulcerative colitis.

5‐ASA suppositories, enemas or foam for induction of remission in ulcerative colitis

Ulcerative colitis (UC) is a chronic condition wherein the innermost lining of the large bowel becomes inflamed. If UC affects only the last part of the bowel (distal UC), medications can be given rectally. 5‐Aminosalicylic acid (5‐ASA) is used commonly to treat mild to moderately active UC. A review of the literature was undertaken to determine how effective rectal 5‐ASA (e.g. enemas, suppositories or foam) is for treating distal UC. Thirty‐eight studies met the criteria for inclusion in the review. Pooled results from these studies show that rectal 5‐ASA is superior to placebo (fake suppositories, enemas or foam) for improving symptoms, improving the appearance of the bowel lining at colonoscopy, and improving the appearance of biopsies of the bowel examined microscopically. Rectal 5‐ASA is also superior to rectal steroids for improving symptoms. Side effects were generally mild in nature and included abdominal pain or distention, nausea and anal discomfort or irritation. From these results, it was concluded that rectal 5‐ASA should be a first‐line treatment for patients with mild to moderately active distal UC.

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