Why am I being treated with 5-ASA?

5-ASA are often used to treat mild to moderate flare-ups of UC. They may then be prescribed to maintain remission and help prevent flare-ups on a longer term basis. The rectal delivered 5-ASA (enemas and suppositories) are really important for helping with symptoms of urgency as they target the distal colon. 

The use of 5-ASA for Crohn's disease is more controversial. Some 5-ASA may help to control very mild CD in the ileum and colon. However, there is little evidence that 5-ASA are effective in maintaining remission, although they may help reduce the chance of CD reoccurring after surgery. 5-ASA are not recommended for severe CD.

How do I take 5-ASA?

Some 5-ASA work best in certain parts of the gut, so you may be prescribed a particular type or brand depending on where you have the inflammation. Many specialists in IBD believe that if a particular brand or type of 5-ASA is working well, you should not be switched to another without a good clinical reason.

Oral 5-ASA were previously prescribed in two or three doses during the day. However, recent evidence suggests that taking these together in a single daily dose can be just as effective. If you feel this could be helpful for you, discuss this with your doctor.

Some 5-ASA come as suppositories or enemas so may be useful if you have proctitis (inflammation of the rectum) or proctosigmoiditis (inflammation of the rectum and sigmoid colon).

Can I take 5-ASA if I have an allergy to Aspirin? What if I have an allergy to sulfa drugs?

CAN I TAKE 5-ASA IF I HAVE AN ASPIRIN ALLERGY?

• There are some similarities between 5-ASA and aspirin and therefore there is a concern of possible cross-reactivity

• There has been a report of successful use of 5-ASA in a patient with aspirin allergy by first using a test dose

• You will have to discuss with your IBD specialist whether to pursue a supervised test dose to assess tolerability or consider desensitization (trying to overcome the allergy by slowly introducing small doses and gradually increasing to full dose)

CAN I TAKE SULFASALAZINE IF I HAVE AN ALLERGY TO SULFA DRUGS?

There may be cross-reactivity if you have a sulfa allergy and therefore alternative medications to sulfasalazine should be considered instead.