Putting Rectal 5-Aminosalicylic Acid in Its Place: The Role in Distal Ulcerative Colitis

I thought maybe I should turn this into it's own post. I have never used 5-asa etc but I know many on here do. So here is a paper that may be of interest.

Putting Rectal 5-Aminosalicylic Acid in Its Place: The Role in Distal Ulcerative Colitis
farncombe.mcmaster.ca/documents/MarshallIrvineAmJGastroenterol20009571628-36.pdf

PS - Dr. Marshall is my current GI... I have no experience with these meds, but I can say that he's a totally awesome GI.

Summary:
"This review summarizes the evidence supporting the role of rectal 5-ASA as a first-line therapy for mild or moderately active distal ulcerative colitis, and offers guidelines for its use."

I would love to know what the hold up is on getting foam in the US. Everything I have read indicates they are easier to retain than enemas and don't require lying still when you are having retention problems.

My last GI told me that Canasa and enemas should never be used for maintenance. I could kick myself for not asking him why. Canasa is an FDA approved maintenance med..most oral 5ASAs never went through the 24 month trial to get approved.

The guidelines for UC as published by the American College of Gastroentorology recommend rectal meds above oral meds alone for distal disease for both maintenance and induction. They recommend rectals be used with orals for induction. No recommendations are made for oral 5ASA delivery types.

I thought this article was interesting:

www.ncbi.nlm.nih.gov/pmc/articles/PMC1773399/

because it concludes with this sentence:"The patient often declares a preference and that is the key to compliance." I guess advertising to patients is money well spent

Here these are two articles written as well from a post I made a while ago. Deal with left sided and right sided etc etc and the difference in meds. I think it compliments the above perhaps. I just copied and pasted it in here:

Old Post
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I think this may help many on or trying 5-ASA's in choosing/fine tuning the best option.

Quite informative and might be important for those of you on 5-asa's and rectal meds etc

It seems to suggest different brands/types have different effects between Right Sided UC, Left Sided UC and Pancolitis etc.

Anyway if you're on 5-asa or rectal meds you might find it of interest to you. I no nothing whatsoever about these drugs and have never taken them....

Part 1
www.gastroendonews.com/download/CC1gense05.pdf
Part 2
www.gastroendonews.com/download/CC2_gense04.pdf

Just into and beyond depending on how much stool is in the colon at the time (in my perspective). But descending colon will be treated with oral mesalamine.
q

Descending colon is tricky to treat. I never got to long-term remission because of that-- 'til I participated in an oral 5-ASA trial for Colazal. (Designed to cleave to mesalamine in the transverse colon, then hits the descending full-force.) Since its generic, Balsalazide, arrived on the market I've been fighting to stay on brandname, which comes in a sturdy capsule. (Not true of some generics!) / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)

I have no symptoms. I want to get the inflammation to mild. I've had no symptoms for over 2 years.

1-3x normal, yes.

50 - Proctitis, 55 - Sigmoiditis, 61 - Pancolitis (after eating raw garlic, my entire colon was inflammed). I've had 2 consecutive scopes since. 63- moderate inflammation in descending and sigmoid. All else returned normal.

Yw