Q&A: Asacol for Ulcerative Colitis Not Being Digested

Patient Expert

I take Asacol for my Ulcerative Colitis, and at times notice the pill come out in my stool undigested. Is this normal?

Passing Asacol tablets in the stool is not an uncommon occurrence. Sometimes just the shell of the pill comes out undissolved, but at times, the entire pill with the medication inside ends up in the stool. It is unclear why this happens, but likely has to do with low acid levels in the intestines not allowing the pill to dissolve. If you are doing well symptomatically, and this happens infrequently, there is nothing to worry about. If however, you are not doing well, or it happens frequently, be sure to notify your physician.

Perhaps you might do better with other Mesalamine products such as Colazol or Lialda that might be better absorbed in your intestinal tract. Also, recently, Apriso, a new form of Mesalamine, was FDA approved for maintenance of remission in ulcerative colitis. The drug is made up of 0.375 grams of Mesalamine, and is the first drug with Intellicor, a combined delayed and extended release. As opposed to being a tablet, Apriso has a gelatin outer cover that quickly dissolves in the stomach dispersing micro granules throughout the gastrointestinal tract. This drug will likely become more popular in the armamentarium against ulcerative colitis.