Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your treatment.

What Is Mesalazine and Why Is It Prescribed?
Mesalazine, also known as mesalamine or 5-aminosalicylic acid (5-ASA), is a first-line treatment for inflammatory bowel disease (IBD). It’s an anti-inflammatory medication that works directly on the lining of your gut to reduce inflammation, swelling, and sores.

Doctors primarily prescribe mesalazine to treat and manage conditions like:

Ulcerative Colitis: It helps to get flare-ups under control (induce remission) and then keep symptoms at bay (maintain remission).
Crohn’s Disease: While used less frequently for Crohn’s than for ulcerative colitis, it can be effective in treating mild to moderate inflammation, particularly in the colon.
You might recognize mesalazine by brand names such as Lialda, Asacol, Pentasa, Apriso, or Delzicol. These different brands have unique ways of releasing the medication to target specific parts of your digestive tract. Because IBD is a chronic condition, many people take mesalazine for months or even years to stay well.

Understanding the Potential Long-Term Risks
For the vast majority of patients, mesalazine is a safe and effective long-term medication. The benefits of controlling IBD and preventing flare-ups usually far outweigh the potential risks. However, like any medication used for an extended period, it’s associated with some potential risks that require monitoring. It is important to know that these serious side effects are considered rare.

Kidney Health (Renal Toxicity)
The most well-documented serious long-term risk associated with mesalazine involves the kidneys. A small percentage of patients may develop a condition called interstitial nephritis, which is inflammation of the tissues within the kidney. If left undetected, it can impair kidney function.

What it is: This condition affects the kidneys’ ability to filter waste from the blood properly. It is not caused by the disease itself but is a specific reaction to the medication in susceptible individuals.
Symptoms to Watch For: Often, there are no early symptoms. However, you should tell your doctor if you notice persistent fatigue, swelling in your legs or ankles, changes in how often you urinate, or nausea.
How it’s Monitored: This is why your doctor will insist on regular monitoring. Before you start mesalazine, you will likely have a blood test and a urine test to check your baseline kidney function. These tests are typically repeated periodically, for example, every few months for the first year and then at least annually after that. This regular monitoring is the best way to catch any potential issues early.
Liver Function (Hepatotoxicity)
While much less common than kidney issues, mesalazine can, in rare cases, affect the liver. The medication can cause inflammation or other liver problems in a very small number of people.

Symptoms to Watch For: Contact your doctor if you experience symptoms that could indicate a liver problem. These include yellowing of the skin or eyes (jaundice), dark-colored urine, severe stomach pain, persistent nausea, or unusual fatigue.
How it’s Monitored: Your doctor may include liver function tests as part of your routine blood work, especially when you first start the medication or if you have a pre-existing liver condition.
Blood Disorders
Extremely rarely, long-term use of mesalazine can affect the bone marrow’s ability to produce blood cells. This can lead to a decrease in white blood cells, red blood cells, or platelets.

What this means: A low white blood cell count can make you more susceptible to infections. Low red blood cells (anemia) can cause fatigue and shortness of breath. Low platelets can lead to problems with blood clotting.
Symptoms to Watch For: You should immediately report any unexplained bruising or bleeding, a persistent sore throat, fever, or feeling exceptionally tired or unwell to your doctor.
How it’s Monitored: A complete blood count (CBC) test, which is a standard blood test, can detect these changes.
Pancreatitis
Inflammation of the pancreas, known as pancreatitis, is another rare but serious side effect. While it can happen at any time, it’s important to be aware of the symptoms throughout your treatment.

Symptoms to Watch For: The main symptom is sudden, severe pain in the center of your upper abdomen that may travel to your back. This can be accompanied by nausea, vomiting, and a fever. If you experience this, you should seek immediate medical attention.
The Importance of Working With Your Doctor
Understanding these risks is not meant to cause alarm, but to empower you as a patient. The key to using mesalazine safely for the long term is building a strong partnership with your healthcare provider.

Attend All Monitoring Appointments: Never skip your scheduled blood or urine tests. These are your doctor’s most important tools for ensuring the medication is not affecting your body negatively.
Communicate Openly: Always tell your doctor about any new or worsening symptoms, even if they seem minor. T