Allergic to mesalamine?

this is hard to know. it would take antibody testing for allergies. Possibly other tests for non-allergic reactions. some people just think they get worse. some people get more symptoms because of coating. some people get more symptoms because of inactive ingredients. some people have reaction to mesalamine. very mixed.

Sometime I get a little uptick in D that I think is caused by my Lialda, but as long as it controls the inflammation, I can handle occasional watery stool.

I had a bad reaction to mesalamines.

First, Rowasa - I generally had abdominal pain and discomfort when using it, but as soon as I was able to retain the enema overnight, I developed cramping, bloody diarrhea, and a lot of it, which was not a normal UC symptom for me (I normally had bleeding but with constipation).

We stopped the Rowasa and then tried it again two weeks later, same result. We also tried Colazal (balsalazide) and that gave me at first bloating, gas and discomfort, lack of appetite, more constipation, and then some painful tenesmus when going.

These symptoms got progressively worse over two weeks, and then I had a sudden and severe worsening of symptoms about two weeks after starting it - 10 trips a day with horribly painful tenesmus and lots of bleeding. We stopped the Colazal and added Cortifoam to the prednisone I was taking, and everything cleared up for the most part. The doctor felt based on the three reactions to Rowasa and Colazal that I'm likely intolerant (not allergic) and we moved on to Remicade.

By now you may have read that mesalamine intolerance causes a paradoxical reaction in those who are intolerant, which is a very small percentage of patients - I think I read a stat of under 5% - but the reaction is a worsening of UC symptoms. This would be distinct from an allergic reaction, which would likely have different symptoms.

If you can't tolerate it, have a chat with your GI for sure. Good luck!

Is mesalamine that bad that we can't all tolerate it in this age of tolerance to everything that's different from ourselves?

For a 5 percent frequency of mesalamine-intolerance, it does seem like a lot of posters here suspect it or test for it. Could be higher, dunno.

But then again, i believe healingwell attracts those with more difficult cases of UC. But i suppose if your UC is no bother and plays nicely you wouldn't google it or seak advice. As it seems there's many surgery and hospitalizations here than the odds would suggest for uc.

No, an intolerance is described as a dramatic worsening of your UC symptoms, like going from 2 formed bms a day with no urgency to going to 8-10 runny bms with a lot of urgency.

An allergy and an intolerance are two different things. If you're having a drug allergy, your immune system gets activated and you show signs of histamine reaction, like hives, diarrhea, cramping, difficulty breathing, or outright anaphylaxis. It happens pretty quick... usually within a day or less.

Intolerance means your body can't metabolize the drug by breaking it down or detoxing it. It's usually a genetic variation in the CYP450 enzymes which most people have a bit of, but you won't know for sure what your configuration is without genetic tests. We can be fast metabolizers, slow metabolizers, or incomplete metabolizers. If you're slow or incomplete, then the drug builds up in your body and causes increasing side effects. If you're an incomplete metabolizer, you eventually have only side effects and no benefits, which is what happens to me with 5-ASAs.

When I was hospitalized with my first flare they gave me 5-ASAs orally and rectally. In 5 days I was vomiting blood and my rectum was bleeding so badly they thought that I had hemorrhaged. It was me who decided to stop the drug, they didn't have an inkling that it had anything to do with it. Meanwhile these side effects are listed. Sometimes I think hospital staff just aren't up to date.

If you suspect a mesalamine-intolerance/allergy, then skip taking it for 48 hours to see what happens. Mesalamine is a 90% topical medication and it will clear from your body in about 24 hours time.

Two possibilities:

1.) If you drop down to 1-2 bms a day without urgency and symptoms then you have a clear-cut case of a bad reaction to mesalamine. By definition, once mesalamine is removed from your system you would feel dramatically better once it is removed from your system if you have a bonafide allergy or intollerance to it. In that eventuality, call your gasteroenteroligist and tell him/her what you experienced and responded after removing mesalamine.

2.) You might not get any better after discontinuing mesalamine for 48 hours. In this eventuality, your UC flare has simply gotten worse: increased in severity and/or extent. The mesalamine is likely helping some, but not enough to keep pace with your UC's progression. Contact your gasteroenteroligist and tell him/her that you need stronger doses, and/or more medications combined to control your UC-symptoms.

Try and see!