Side effects
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Side effects
For anyone who is taking/has taken Lialda or other mesalamine containing products -- did you ever experience white stool? My doctor upped my dosage from 2.4g a day to 4.8g per day. Ever since then, I've been experiencing white stool. It's not all white, just parts of it. It appears normal, does not look like fat malabsorption or anything like that. I have a friend with UC who told me she experienced the same thing but it resolved after stopping the mesalamine.
Hi Bearcat,
If you Google it, you'll find that it's somewhat commonly-reported by some mesalamine users. Reports of entire pills (or shells) showing up in stool are more frequently seen, especially for Asacol users. Some of the enteric coatings used on these products apparently are unable to respond (break down) fast enough to be able to accommodate the rapid transit often experienced during IBD flares. By the time they fully activate, they look around and discover that they are in the toilet.
Presumably most of the enteric coatings are designed to respond most effectively with normal motility rates, and of course most people who need such treatments can only dream about normal motility rates. 
Such treatments usually still help, but they don't necessarily provide full effectiveness, because they become fully activated a bit too late in the trip. Ideally, they should begin to activate in the ileum (where the inflammation typically begins), and that should allow them to be fully activated by the time they get about half way through the colon.
Tex
If you Google it, you'll find that it's somewhat commonly-reported by some mesalamine users. Reports of entire pills (or shells) showing up in stool are more frequently seen, especially for Asacol users. Some of the enteric coatings used on these products apparently are unable to respond (break down) fast enough to be able to accommodate the rapid transit often experienced during IBD flares. By the time they fully activate, they look around and discover that they are in the toilet.
Presumably most of the enteric coatings are designed to respond most effectively with normal motility rates, and of course most people who need such treatments can only dream about normal motility rates. Such treatments usually still help, but they don't necessarily provide full effectiveness, because they become fully activated a bit too late in the trip. Ideally, they should begin to activate in the ileum (where the inflammation typically begins), and that should allow them to be fully activated by the time they get about half way through the colon.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
I've seen reports of patches of white on stool, that were blamed on mesalamine. But yes, if you are talking about the overall stool color, that's an entirely different matter. That's usually attributed to a lack of bile in the stool, such as in the case of a bile duct obstruction. But the only way that I am aware of that mesalamine would interfere with bile flow, would be when it induces liver injury as in the case of "vanishing bile duct syndrome".
You might be interested in the article at the following link:
It probably would be a good idea to stay away from mesalamine if you are fond of your liver.
Tex
You might be interested in the article at the following link:
http://livertox.nlm.nih.gov/Mesalamine.htmHepatotoxicity
In large registration trials of various forms of mesalamine, serum enzyme elevations were no more common with the products than with placebo therapy and were less common than with sulfasalazine. In these large studies, there were no reported instances of clinically apparent liver injury. Since approval and wide scale usage, however, there have been isolated reports of acute and chronic liver injury with jaundice attributed to mesalamine therapy. Clinically apparent liver injury is estimated to occur at an incidence of 3.2 cases per million prescriptions. Several patterns of injury have been reported, including asymptomatic and mild elevations in serum ALT levels, mild hepatitis accompanying a hypersensitivity reaction within a few days or weeks of starting (sometimes following a similar reaction to sulfasalazine), and more typically, idiosyncratic cholestatic (Case 1) or hepatocellular liver injury, which typically arises after 1 to 6 months of treatment and is not accompanied by signs of hypersensitivity (rash, fever, eosinophilia). Most cases of liver injury with jaundice have been mild-to-moderate in severity and no instances of fatal acute liver injury, chronic hepatitis or vanishing bile duct syndrome attributable to mesalamine have been reported.
It probably would be a good idea to stay away from mesalamine if you are fond of your liver.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.