Miscellaneous Ulcerative Colitis & 5-ASA Information

Patient Expert

Ten years ago when I was finally diagnosed with UC I was given Asacol, a 5-ASA drug, to get the inflammation in my colon under control. Today, even though my symptoms are under control I still continue to take a low maintenance dose. And, my Dad who had pretty severe UC for nearly 30+ years thought he was in the clear after not having any symptoms or flare-ups for ten years or so. That was, until a couple of months ago when he had a routine colonoscopy. He felt great but the scope showed some inflammation in his colon. His doctor prescribed Asacol telling him that he needed to get the inflammation under control so that it didn't pose more serious problems for him down the line.

In a study published by Medscape on their web site last week I was interested to read their point that UC patients taking maintenance therapy drugs are at a much lesser risk of experiencing a symptomatic relapse, or flare-up, than those patients not taking maintenance medications. Without the maintenance drugs, the study says, the majority of UC patients will experience symptomatic relapse at some point over a five year period of time. And relapse can put the UC patient at greater risk for future colectomy surgery and colorectal cancer.

Those medications shown to help UC patients maintain remission include:

1. 5-ASA's which include: Ascaol, Lialda, Pentasa, Dipentum, and Colazal

2. Azathioprine

3. Infliximab

If you're one of the many UC patients taking a 5-ASA the next question is, have you noticed an unsightly polka-dot like stain on the underside of your toilet seat? I noticed this about a year after I started taking Asacol and I know other people I've talked to who take Pentasa and Colazal have the same problem. As I understand it, this is the 'waste' from the enteric coating that these pills are encased in and it comes out in your urine. I think a female is much more likely to see this 'splash back' pattern on the underside of the toilet seat than a male, but I've heard the gripe from both sexes. So, what's to be done to get rid of the stains? After trying many different methods and buying too many new toilet seats over the years I've finally found a method that seems to work - dab Soft Scrub onto the toilet seat stains in a thick layer and let stand for at least 15 minutes, half an hour is even better, then scrub with a wet Mr. Clean Magic Eraser pad and wipe off the residue with a paper towel. Voila your toilet seat should now look pretty near to when it was new. Unfortunately this isn't a one-time thing and others claim that if they wipe the underside every day or two with a Clorox wipe that keeps the stains at bay. (Note: I've not been paid by any of these companies to endorse these products, they are just what seem to work for me.)

My next piece of information is off the topic of 5-ASA drugs but still on the topic of UC/IBD. I've not taken an NSAID (non-steroidal anti-inflammatory drug) - drugs like Aleve, Motrin, aspirin, ibuprofen, naproxen, Vioxx, Celebrex, etc. since the onset of my IBD symptoms eleven years ago when my GI told me they could further aggravate my IBD. Over the years I've also talked to numerous patients who said the onset of their IBD or IBS symptoms came either while or recently after taking high doses or prolonged doses of NSAIDs. While the Crohn's and Colitis Foundation of America (CCFA) recommends against people with IBD taking NSAIDs, there are those who contend that the drugs do not affect all people with IBD adversely and that in some cases the benefit of taking an NSAID may outweigh the potential risks of taking these drugs. So, this is another case where the patient should be aware of the potential risks of taking these medications and discuss his or her best pain relief options with their doctor.