From the Research
Mesalamine (5-aminosalicylic acid) typically does not need to be stopped prior to colonoscopy. Patients can continue taking their regular mesalamine medications, including oral forms (tablets, capsules) and rectal forms (suppositories, enemas), right up to the day of the procedure. However, on the day of colonoscopy, patients should follow their healthcare provider's specific instructions regarding morning medications. The rationale for continuing mesalamine is that it does not interfere with the bowel preparation process or affect the visualization of the colon during the procedure, as supported by studies such as 1. Additionally, maintaining mesalamine therapy helps prevent disease flares in patients with inflammatory bowel disease.
Some key points to consider:
- Mesalamine is a first-line therapy for ulcerative colitis, and its continuation is crucial for maintaining remission, as noted in 1.
- The bowel preparation solution itself is the primary factor in achieving a clean colon for optimal visualization during colonoscopy, not the temporary discontinuation of mesalamine.
- Patients should inform their gastroenterologist about all medications they are taking, as individual circumstances may occasionally warrant different recommendations.
- It's essential to follow the healthcare provider's instructions regarding morning medications on the day of the colonoscopy to ensure the best possible outcome.
The most recent and highest quality study, 1, published in 2020, confirms the efficacy and safety of mesalamine in patients with mild to moderate ulcerative colitis, further supporting the decision to continue mesalamine therapy before a colonoscopy.