Ulcerative Colitis Medications - Mesalazine
Mesalazine - the most well known brand of which is Asacol is the
first line of attack in both the treatment and maintenance of Ulcerative
Colitis. It is part of a family of drugs called aminosalicylates
- and can be delivered either orally or as an enema (know as topically - to the "outside" surface of the bowel).
The drug is not effective immediately - and it is usually 2-3 weeks
before the full benefits are seen.
Oral mesalazine tablets used to treat Ulcerative Colitis are coated
with an enteric coating. This coating protects the drug through
the stomach and small intestine - and releases it when it reaches the
less acid environment of the Colon. This form of mesalazine works
best when the stools are reasonably solid - as when there is severe
diarrhea the drug often passes through the colon with the enteric coating intact - so the drug isn't released.
Mesalazine enemas are used to get the mesalazine directly in contact
with both the rectum and descending colon. The best are probably
Asacol foam enemas - capable of reaching nearly the whole of the
descending colon. So long as these enemas can be retained for a
reasonable time before you pass them they are extremely effective.
They are particularly useful in the case of diarrhea - where oral
mesalazine can become less effective
Colazide is a more precise way of delivering mesalazine to the
colon than enteric coated tablets. The enteric tablets rely upon
change of acidity to release the drug - meaning that it can often
be released in the small intestine. Colazide is mesalazine chemically
bound to prevent it's absorption. Bacteria only found in the colon
attack this chemical bond - and release the mesalazine.
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