I was reading some posts earlier this week and I thought I came across one that mentioned long term usage of 5ASAs contribute to triggering of other AI diseases? I cannot find the post anywhere and when running a Google search do not come across anything as well. I believe Tex mentioned this. Is this legitimate, and if so, what science backs it up?
As an update, on my final month of tapering Endocort. Still feeling and doing great since Day 1. Have been gluten free as well, as well as a large diet of supplements. Hoping that helps when I go off completely!
? re: long term side effects of 5ASA for maintenance?
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Meggie1129
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I don't recall that post, but I suppose that it is indeed possible that mesalamine-based anti-inflammatories could lead to the development of additional AI diseases for IBD patients who are sensitive to NSAIDs. Here's my reasoning:
Bear in mind that 5-ASA medications (mesalamine) are derivatives of salicylic acid. Published case studies show that at least for IBD patients who are sensitive to NSAIDs, mesalamine can lead to the production of leukotrienes, similar to NSAIDs, resulting in diarrhea/inflammation. Here's a link to an article:
Diarrhea Associated with Mesalamine in a Patient with Chronic Nongranulomatous Enterocolitis
Chronic nongranulomatous enterocolitis is an alternate name for MC (which is rarely used these days). And of course all AI diseases are caused by chronic inflammation. That's why the first AI disease often leads to others, because the medical community treats the symptoms with drugs to mask the inflammation, rather than to stop the source of the inflammation. Obviously though, this risk would only apply to certain patients, because not everyone is sensitive to NSAIDs.
Incidentally, the latest guidelines issued by the American Gastroenterological Association Institute for the medical management of microscopic colitis no longer recommend mesalamine as a first line of treatment except in cases where budesonide is not an option. You can see a summary of those recommendations at the link below (scroll down almost to the bottom of the page at this link):
http://www.microscopiccolitisfoundation ... tions.html
Or you can open a PDF copy of the original publication from there, if you wish.
Tex
Bear in mind that 5-ASA medications (mesalamine) are derivatives of salicylic acid. Published case studies show that at least for IBD patients who are sensitive to NSAIDs, mesalamine can lead to the production of leukotrienes, similar to NSAIDs, resulting in diarrhea/inflammation. Here's a link to an article:
Diarrhea Associated with Mesalamine in a Patient with Chronic Nongranulomatous Enterocolitis
Chronic nongranulomatous enterocolitis is an alternate name for MC (which is rarely used these days). And of course all AI diseases are caused by chronic inflammation. That's why the first AI disease often leads to others, because the medical community treats the symptoms with drugs to mask the inflammation, rather than to stop the source of the inflammation. Obviously though, this risk would only apply to certain patients, because not everyone is sensitive to NSAIDs.
Incidentally, the latest guidelines issued by the American Gastroenterological Association Institute for the medical management of microscopic colitis no longer recommend mesalamine as a first line of treatment except in cases where budesonide is not an option. You can see a summary of those recommendations at the link below (scroll down almost to the bottom of the page at this link):
http://www.microscopiccolitisfoundation ... tions.html
Or you can open a PDF copy of the original publication from there, if you wish.
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.