Long term side effects of mesalamine

I’ve been on Asacol for decades (2400mg/day) and have started having possible kidney issues, originally thought to be a UTI and treated twice by ob-gyn with antibiotics which relieve symptoms but now, with 3rd occurrence, am told I need to see a urologist … very worried that my body (kidneys) no longer will tolerate Mesalamine … would really like to hear from others that may have experienced similar long term side effects and how you now treat your UC (and if your kidney problems were reversed)

Thank for your comments.
No kidney function tests have been run on me for a few years. Cultures were done by ob-gyn and negative and he said if they were negative that I need to see a urologist … latest urinalysis lab results were only available late Friday afternoon - as he recommended, I’ll phone ob-gyn on Tuesday to request a referral to urologist (per insurance requirement). In the meantime, I worry.

I've been on oral mesalamine daily for years. My longtime gastroenterologist subspecializes in IBD treatment and orders my blood test for EGFR (Estimated Glomerular Filtration Rate) kidney function twice a year. That test yields a higher and lower estimate of the patient's serum creatinine concentration, where age and gender get factored in. The range for normal results is 60 to 90 something. *** FYI, in post-menopausal females it is more common to experience bladder problems because the mucosa tends to thin with aging, thereby making one more vulnerable to infection by pathogens. However, not all urine cultures showing higher than normal range bacteria, for example, should be treated with antibiotics. (Which can aggravate UC.) A couple years ago my gyn got a lab report of 10,000 units specific bacteria found in my culture, and recommended against antibiotics because my only symptom was slight urgency. I then drank extra water for the following weeks and overcame the problem, as repeat culture verified. *** It would seem reasonable for your docs to order both urinalysis complete and urine culture if you feel kidney area discomfort or experience voiding problems, and then proceed from there; just be aware that mesalamine may not be the cause, and you should keep well-hydrated in any case and try not to worry. Best wishes for a speedy resolution to any problem. / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)

Thank you all for your valuable information - I’m less concerned that my oral mesalamine is the cause (phew!) and wouldn’t be surprised if all stems from Post menopausal issues. I’ll be working toward seeing a urologist and will update my status once I have answers.
Thank you for taking the time to provide your insights

Post Edited (UC prisoner) : 9/6/2022 2:57:23 AM (GMT-7)

I had a pretty bad case of IC last year. After I went back on SCD diet pretty strictly, it cleared up. I think it helped overall in getting inflammation down. Ive been on sulfasalazine for about 30 years, i think thats similar isnt it?

If your UT symptoms include urgency, it can help to eliminate caffeine sources and excessive amounts of vitamins B & C. I got that advice a while back from a rehab MD specializing in (female) pelvic floor issues. The old thinking was that vit B excess didn't matter because B is water-soluble, but more recent attitude is that it can still build up too much in us older gals via daily supplements, or fortified foods like cereals. Rehab MD's advice led me to scrutinize my blood labs more carefully, then I saw that my B levels were quite high over time, but never got "flagged" as a problem in the automatic report generating system used by gastroenterologist. Thereafter, I changed my daily multivitamin to alternate days and the various B vitamins then registered within normal range on succeeding lab tests. It did relieve my UT symptoms, indicating that the "culprit" troubling us can be something other than a pathogen. / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)

UC prisoner said...
@quincy
I was just reading about diagnosing interstial cystitis via cystoscopy and saw that a hydrodistension can be done at the same time so this could be why your symptoms have abated. I normally don’t drink much coffee (one of the dietary restrictions recommended for IC) but was drinking quite a bit prior to my last episode so perhaps that effected me. Again, I’ll update this post when I have an official diagnosis.

Coffee hasn't caused me any issues before or after, and I drank at most 8 cups a day...urgency wasn't an issue, but spasming was. But it was a relief to not have it. My cat had it for 5 years before she died at age 20 ...it was hell.
It is an autoimmune disease...as if one isn't enough, and they love to party together...linked or not.

Keep us updated for sure.

q

I just realized I neglected to update … urologist appointment and dx with an overactive bladder … and yes caffeine (among other things) contribute to it. I have eliminated coffee and stopped my addiction with carbonated mineral water (carbonated beverages are also not recommended) Much improvement … now if I can keep up with pelvic floor exercises which I seem to neglect …

Urologist reran urine tests/blood work and all was good. Discussions of symptoms led him to that dx.
Carbonated water is so refreshing, especially in hot weather. My cousin, who is an MD, also advised me to kick the habit but never felt any UC symptoms from it so no need to stop the habit until recently. I was also drinking lots of espresso prior to my episodes so that definitely played a role too. If I start to have infection like symptoms again I will follow up with urologist (instead of gynecologist). 6 months already and So far so good.

Love everything espresso - a good demitasse of one, cappuccinos, tiramisu, and my new summer favorite.. affogato
I still treat myself to an occasional indulgence.
Find coffee harder to eliminate than alcohol (don’t miss alcohol at all but still crave coffee)