5ASA's bad for the liver?

I thought they were bad on the kidneys?

Some cannot take them, some have those side effects where liver or kidneys or lungs over long-term use are affected. But for UC and if one can take them, they're still the best bet with the least side effects.

I've taken them for over 21 years, and I do have UC-related liver disease. I wouldn't stop them EVER for the above suspected reasons, especially since it's done so well to control my UC....and the added benefit is that the 5ASA meds are strongly believed to help prevent colon cancer.

Salicylates are an amazing med....their benefit to all organs are amazing! But, again, for some they're a total no-no.

q

I found this on side effects of Colazal pertaining to liver:

Hepatic side effects have included elevated liver enzymes, jaundice, cholestatic jaundice, cirrhosis, and hepatocellular damage. Liver necrosis and liver failure have been reported in postmarketing clinical trials, although no causal relationship has been established. Hepatotoxicity, including elevated liver function tests (SGOT/AST, SGPT/ALT, GGT, LDH, alkaline phosphatase, bilirubin), jaundice, cholestatic jaundice, cirrhosis, hepatocellular damage including liver necrosis, and liver failure have been reported during the postmarketing of products that contain (or are metabolized to) mesalamine. One case of Kawasaki-like syndrome, which included hepatic function changes, has been reported.

I imagine all 5-ASA drugs have similar information.

MyUC,
How do you know your kidneys were effected if you don't mind me asking?

Asacol wouldn't be undigested flowing through your bloodstream since it's only dispursed in your colon. Unless you have huge holes in your colon for it to be taken up by the bloodstream???

Yes, high 5ASA meds can affect the body....


Rectal meds....now you know about them MyUC....I'm not surprised about the lack of prescriptions regarding them, but still shocked.

Deltaforce....I wouldn't stay on Naproxen ..... maybe something else?


My UC-related liver disease is primary sclerosing cholangitis, visually positive from an MRCP, but my blood tests also conclude Primary Biliary Cirrhosis...do I have both? who knows,

q

Asacol and other the pills are systemically absorbed(enter the blood stream/pass through the liver and kidneys) at a rate of 20-30% depending on the particular medication.

In Rectal medications it is 17-77%.

The amount absorbed especially in rectal meds varies quite a lot person to person.

Action is believed to be topical but that doesn't mean the body doesn't absorb it.

Keep in mind that studies of maintenance level are limited to one year. High doses to induce remission are limited to 6-8 weeks. There are no studies using both high dosage(like 4.8gr asacol) and rectal medications. Lots of doctors are prescribing the higher dosages. Animal studies show that very high dosages are required to cause organ damage or death. It is a relatively "safe" drug.

The kidney problems are much more common than liver but both are rare. You have to look at the alternative risks of not using these drugs which is riskier drugs or severe disease. This is probably why some doctors are hesitant to prescribe pills, suppositories and enemas and let patients dose themselves up good.

The RXlist has Clinical Pharmacology on all medications.

www.rxlist.com/lialda-drug.htm

I don't think people fully understand the importance of the liver. In fact, a faulty liver can result in auto-immune diseases, because the liver doesn't digest everything properly. The body views the undigested chemicals, preservatives, ... as foreign bodies and starts attacking them.

Subdued,
I believe it's the pancreas which produces digestive enzymes which help to digest food. Most people with AI disease have low pancreatic enzymes, causing what you've described. The liver's job is to remove toxins from the body.

Yes but I believe (and could be very wrong) that it's the low pancreatic enzymes which are thought to result in a leaky gut and AI disease.

MyUC,
That's the position taken by many alternative practitioners working with IBD. I'm sure your GI never told you about the "leaky gut' aspect of IBD? That's probably considered quackery too by them but in fact if you do a pubmed search you will find many studies which confirm the this "theory" and take it as a starting point. People with IBD (and AI disease) do suffer from a leaky gut. It causes an immune response. One theory is pancreatic enzyme difficiency. You've mentioned in your posts that your past GIs never suggested probiotics? After so many years with UC? With all do respect to you, I would take what your GI tells you or doesn't tell you to be the gospel. Not my area either, but then I do feel I knew a lot more about UC than my daughter's first "IBD expert" GI. And I am in no way being arrogant. I'm sorry I allowed her to treat my child for five minutes much less three months.

Don't know Levi. My daughter's on sulfasalazine (until I can get her off, that's my personal preference) but of course it's just one more thing to stress about! Kidney disease is so terrible, I have it in my family, I'd rather just have the colectomy personally and move on. Who knows, that may be where we (my daughter and us) are headed? I hate this.

quincy said... Deltaforce....I wouldn't stay on Naproxen ..... maybe something else? Every time I even THINK of going near Naproxin I'm begging for a flare. It's a shame too, pre-UC is was my favorite OTC pain reliever.