Diarrhea as a side effect of mesalamine treatment for inflammatory bowel disease

Tablets of coated 5-aminosalicylate (5-ASA) called mesalazines are among th e most widely prescribed preparations for the treatment of colitis, includi ng ulcerative, Crohn's disease (CD), collagenous and lymphocytic colitis. a nd-to a lesser extent-CD of the small bowel. Mesalamines have, to a large e xtent, replaced the parent drug sulfasalazine because they produce fewer si de effects. Although mesalamines have been known from earlier studies to pr oduce occasional diarrhea, the true incidence of this effect is not known a nd is nor always recognized. We are presenting the cases of five patients i n LI hom oral mesalamines produced severe and persistent diarrhea-made wors e by increasing doses of the drug-and intensified the colitis in two. Recog nition of the problem is by symptom analysis after careful history taking. Changing the therapeutic regimen or discontinuing the medication is usually required to reverse this potentially debilitating and occasionally life-th reatening side effect.