Aminosalicylates for Inflammatory Bowel Disease

These medicines are effective for mild to moderate ulcerative colitis and mild Crohn's disease. Their use depends on the type of medicine (oral or topical) and whether it treats disease that is active or in remission.

Ulcerative colitis

Treatment for mild to moderate ulcerative colitis often begins with sulfasalazine. Sulfasalazine works 40% to 80% of the time to make ulcerative colitis symptoms better or keep them from coming back.^{Reference 1} But it cannot be used by people who are allergic to or cannot tolerate sulfa drugs.

Mesalamine, olsalazine, and balsalazide do not contain sulfa. So they may be used to treat mild to moderate ulcerative colitis if you cannot take sulfasalazine.

Mesalamine enemas are effective in treating symptoms of mild to moderate distal (left-sided) ulcerative colitis and in maintaining remission.^{Reference 1} Mesalamine suppositories are preferred for people who have proctitis. The combination of a mesalamine pill (oral) and a mesalamine enema, foam, or suppository (topical) works better to treat left-sided colitis than either oral or topical mesalamine by itself.^{Reference 1}

These medicines can be used to maintain remission in ulcerative colitis.

Crohn's disease

Aminosalicylates do not seem to keep symptoms from coming back when a person is in remission caused by drugs (like corticosteroids). But aminosalicylates sometimes keep symptoms from coming back in people who have had surgery.^{Reference 2} Some people are allergic to sulfa drugs and cannot take sulfasalazine.

Mesalamine has been shown to stop the symptoms of Crohn's disease in some people. Studies show that about 45% to 55% of people treated with mesalamine go into Reference remission Opens New Window (a period without symptoms).^{Reference 3}

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