Lialda is a brand name of mesalamine that is specifically formulated for treatment of Ulcerative Colitis as the medicine is released in a manner where it treats inflammation located in the colon. This is because it is coated with a pH dependent polymer film that breaks down at pH 6.8 or higher which is usually in the terminal ileum though varies from person to person.[1]

As mesalamine acts topically, it works well for Ulcerative Colitis as UC only affects the mucosal layer of the intestines. Conversely, Crohn's disease is transmural, meaning it can affect every layer of the intestinal wall so a topical anti-inflammatory likely won't work well.

We often see patients with Crohn's disease in the small intestine on Lialda alone. In such a situation, it is very likely the wrong medication to be on and you should discuss additional treatment options with your doctor.

Mesalamine-Induced Acute Intolerance Syndrome

Mesalamine can cause acute intolerance syndrome and the symptoms can be hard to differentiate from the IBD. About 3% of patients are thought to get acute intolerance syndrome. The symptoms may include bloody diarrhea, abdominal pain, cramping, fever, rash, and/or headache. As such, anyone taking Lialda should be closely observed for worsening of these symptoms if they are already present from IBD.

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