New article on 5-ASA's and Balsalazide

I cannot pretend to understand all the technical stuff written in this article. But took away just a few things:

1-Topical mesalamine (enemas/suppositories) gave better results than oral meds with fewer side effects. But a combination of oral and topical mesalamine was best, even better than steroids.

2-Balsalazide gives superior results compared to ph-dependent mesalamine and quicker improvement in left-sided UC. Right-sided UC patients had less rectal bleeding and better sig.-scope healing with balsalazide.

Interested to see what others find of importance.

www.gastroendonews.com/ViewArticle.aspx?d=Clinical%2BReviews&d_id=192&i=July%2B2011&i_id=748&a_id=18439&ses=ogst

click on the PDF document

Oh I didn't know you had to register. Let me see what I can do to make it better.

Let me know if you can read this pdf
www.gastroendonews.com/download/5ASA_GEN0711_WM.pdf

This looks interesting, Imagardener. Thanks for posting it. I downloaded it and will try to read the whole thing tomorrow when I'm not brain dead as I always am at the end of the day.

I didn't read the article but these are the things that my GI has already told me. When I switched from Asacol to Colazal (6 - 7 years ago??) he said that Colazal would probably help me better then Asacol since I have left sided. And it did. I did a ton better on Colazal then I ever did on Asacol.

Your GI sounds smarter than all my past/current GI's. If yours knew this 6-7 years ago why was I kept on Asacol for so long? Maybe I didn't complain enough about non-improvement on Asacol? But I think I did. My diagnosis is left-sided also. But I will say that I did not think Balsalazide helped either, at least I had no improvement on it after several months which is why I started my last and successful diet modification.

Just for readers who may be confused--Balsalazide and Colazal are the same drug although some people have reported intolerance of Balsal. and are fine on Colazal. Balsalazide is generic, Colazal is name brand in US.

The article only refers to Balsalazide but I would think you can interpret that as Colazal also.

Very interesting article. So why does it seem that many Gi's do not treat from both ends? Do they read the latest articles?
B

That rectal 5asa is superior to oral for UP and rectosigmoiditis has been around for years. The compliance issue ,which I think is bogus, is the reason doctors don't use it. Oral and rectal for extensive disease has been around many years also. Again compliance and cost. The cost issue does make sense if your are treating somebody with less severe disease. Incidentally 5asa enemas every third day exceed 2.4 g daily of asacol for maintenance.

I asked for balasalzide after reading the clinical trials. The trials either point to superiority or just a slight edge for distal and left side. Articles since these trials make claims that in practice balasalazide is not as good as expected. These are never backed up. I assume doctors are switching people that asacol
didn't work on then comparing these people to those that asacol did work on. Faulty logic.

The new things in the article to me were that it explained how they figure out where the various pills deposit 5ASA. They are collecting mucous samples! The other is the idea of mixing various oral meds. This maybe a breakthrough idea for people with non-typical UC and crohns. The last new thing is the idea that IBD is not just UC and Crohns but a whole array of diseases with similar symptoms. Well actually that gets talked about here all the time.

If you want some easier reading to back up the article try this:

/www.med.upenn.edu/gastro/documents/ACGguidelinesforulcerativecolitis.pdf

PDF download

Post Edited (AZYooper) : 7/29/2011 5:59:56 PM (GMT-6)

This article is a rehash of one I posted about 2-3 yrs back from the same Website. I think Fruitgirl intended to link it in the Resources section. Nothing really new here-- except that gastros have come to realize that the delivery mechanism of the oral mesalamine is more important to efficacity in combatting inflammation than total amount of med swallowed daily. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)