While Crohn’s disease generally involves an inflammation of the gastrointestinal tract, in some patients, symptoms are localized to a specific area. For patients with localization—specifically in the rectal area—aminosalicylates, prescribed to reduce inflammation of the intestine, can provide some relief.
Since Crohn’s disease has no known cure, remission is the goal for most patients. Some medications can help a patient achieve remission or, at the very least, provide temporary relief from symptoms. Aminosalicylates are specifically administered in the rectal area, sending treatment directly to the affected area. Since aminosalicylates are often less potent than other medications for Crohn’s patients, they are often prescribed to patients suffering less severe Crohn’s symptoms.
For patients in a remission induced by corticosteroids, aminosalicylates have not shown success in preventing symptoms from returning. However, aminosalicylates have shown successful in Crohn’s patients that have undergone surgery. While aminosalicylates tend to be safer than some other treatments, patients sometimes have to take large amounts of medication to achieve the desired results. Aminosalicylates come in pill, suppository, and enema form and while some patients will emphasize one form of treatment, many physicians have found that a combination of the three types of medications work best.
Balsalazide is an anti-inflammatory medication that reduces Crohn’s Disease symptoms like diarrhea and rectal bleeding. Prescribed in capsule form, balsalazide is a short-term prescription to relieve symptoms, usually taken for only eight weeks— or twelve weeks at most.
Side effects can include insomnia, headaches, and constipation, while more severe rare side effects can include yellowing of the skin or eyes and rectal bleeding. Consult the full list of side effects before beginning treatment with balsalazide.
Also known as 5-ASA, mesalamine has a similar chemical composition to aspirin. While aspirin is not an effective treatment for Crohn’s disease, 5-ASA can be effective if delivered directly to the lining of the colon. The enema version of 5-ASA is Rowasa, which is most effective in treating inflammation of the rectal area. 5-ASA in suppository form is Canasa, which is usually used as treatment for ulcerative colitis patients. In studies, remission was achieved in approximately half of all patients who received mesalamine treatment.
One study has shown that another added benefit to mesalamine is a reduction in the cases of colorectal cancer in patients who this medication. The study concluded that mesalamine, when combined with folic acid, may decrease the incidence of colorectal cancer among patients dealing with bowel inflammation issues.
Olsalazine, prescribed under the brand name Dipentum, is also geared toward ulcerative colitis patients. In those patients, Dipentum is prescribed to keep symptoms from returning in patients who are in remission. While olsalazine may have possible benefits to Crohn’s patients, it is not a preferred treatment at this time.
Crohn’s patients dealing with the pain and inconvenience of diarrhea and abdominal pain may find relief in sulfasalazine. Prescribed as Azulfidine, sulfasalazine reduces swelling throughout the body via time-release caplets.
Patients are instructed to take sulfasalazine on a set schedule—usually four times a day—and should continue to take sulfasalazine daily until your doctor instructs you to stop. Some patients mistakenly discontinue the medication once they are feeling better, which is not advised.
Some of the more serious side effects can include pale or yellow skin, difficulty swallowing, or unusual bleeding. Patients who are allergic to sulfa drugs will likely find they should avoid Sulfasalazine.
Sulfasalazines have a few rare but dangerous side effects. In less than one percent of cases, an inflammation of the liver or lung occurs. Stevens-Johnson Syndrome, a hypersensitivity reaction that occurs when taking certain medications, is another side effect. This is important to note because Stevens-Johnson Syndrome is a fatal condition. Patients who notice symptoms such as fever, feeling ill, or itching and aching should consult their physician immediately.
Side effects of Aminosalicylates
?Generally speaking, aminosalicylates can cause a variety of side effects, including infertility in men. Lower sperm count is a side effect in some men, but it should be noted that this side effect can reverse once a patient discontinues taking aminosalicylates.
The most common reported side effect is headaches, reported by around one-third of all patients who take Aminosalicylates. Suddenly increasing the dosage of aminosalicylates can exacerbate headaches, so many physicians will recommend a gradual increase. Since headaches seem to occur more often with higher doses, your doctor may recommend lowering your dosage if headaches are a problem.
Unlike other medications prescribed for Crohn’s disease, aminosalicylates can be taken long-term. They are considered maintenance medications for Crohn’s patients, providing a reduction of symptoms while being safe enough to use for long periods of time.