mesalazine / Generic mfg. - LARVOL DELTA

Salmonella Typhimurium infection complicating very early-onset inflammatory bowel disease presenting with Pseudo-intussusception: a case report. (PubMed, Front Pediatr) - "The patient received a combined regimen of systemic intravenous cefotaxime sodium and localized therapy comprising dexamethasone retention enemas and mesalazine suppositories, with symptom resolution within 10 days. This case illustrates the value of multimodal imaging and early endoscopy in differentiating overlapping enteric infections from VEO-IBD, and suggests that integrating systemic antimicrobials with localized anti-inflammatory agents may be a feasible therapeutic strategy."

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Pain

A Rare Case of Mesalamine-Induced Accelerated Histiocytoid Sweet Syndrome in a Patient Treated for Colitis (ACG 2026) - "The patient was started on mesalamine suppositories...Mesalamine was discontinued and she was treated with topical clobetasol and oral antihistamines...Middle column: Skin biopsy immunohistochemistry showing a perivascular and interstitial histiocytoid infiltrate with positive staining for CD14, MPO, and MXA. Right column: Erythematous, tender papules on the dorsal hands, forearms, and lower extremities."

Clinical • Dermatology • Gastroenterology • Gastrointestinal Disorder • Immunology • Musculoskeletal Pain • Pyoderma Gangrenosum • CD14

Not Your Typical Vaginal Bleed: Inflammatory Bowel Disease in a Sigmoid Neovagina (ACG 2026) - "The patient was managed with IV methylprednisolone initially, and soon transitioned to infliximab infusion every 8 weeks, with significant improvement in symptoms. Her vaginal symptoms have stayed in control with mesalamine suppositories...The association between UC and neovaginal bleeding underscores the need for careful monitoring and early intervention in such complex cases to prevent further morbidity and improve patient outcomes. Figure: Colon Biopsy Figure: Vaginal Biopsy"

Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis

Refractory Hemorrhagic Radiation Proctitis Managed With Sequential Endoscopic, Topical, and Hyperbaric Oxygen Therapy. (PubMed, Cureus) - "He subsequently received compounded sucralfate enemas with improvement in bleeding, followed by repeat endoscopic treatment of residual radiation proctitis with APC. Due to persistent symptoms, mesalamine suppositories and rectal radiofrequency ablation were used...Biopsies were negative for cytomegalovirus (CMV), herpes simplex virus (HSV), and dysplasia. This case highlights the stepwise and often multimodal management required for refractory chronic radiation proctitis and supports consideration of hyperbaric oxygen therapy when bleeding persists despite topical and endoscopic interventions."

Journal • CNS Disorders • Cytomegalovirus Infection • Gastrointestinal Disorder • Genito-urinary Cancer • Hematological Disorders • Herpes Simplex • Oncology • Prostate Cancer • Solid Tumor

Development and validation of an in vitro permeation test method for rectal mesalamine suppositories. (PubMed, Int J Pharm) - "The results of our research demonstrated the feasibility of utilizing IVPT studies with mucosal tissues to evaluate the in vitro performance of locally-acting rectal semisolid drug products. Data from such studies are in vitro surrogates that are expected to enhance our understanding of local drug bioavailability from these drug products and may contribute to an overall assessment of bioequivalence in the future."

Journal • Preclinical

Fecal calprotectin predicts relapse in ulcerative proctitis: a 12-month prospective cohort study (ECCO-IBD 2026) - "Methods A multicenter, prospective, observational study was designed in patients ≥18 years old with UP (defined according ECCO guidelines) under maintenance treatment with mesalazine suppositories...Conclusion This large prospective multicenter cohort of patients with UP demonstrated that FC was an independent predictor of relapse. A cutoff of 40 µg/g, notably lower than typically applied thresholds, showed a high negative predictive value and reliably identified patients at low risk of clinical relapse."

Clinical • Inflammatory Bowel Disease • Ulcerative Colitis • Ulcerative proctitis

Neovaginal Diversion Colitis Successfully Treated With Mesalazine Suppositories: Endoscopic Documentation of Healing. (PubMed, Dig Endosc) - No abstract available

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology

Toxic Proctitis of the Hartmann's Pouch Requiring Proctectomy in Ulcerative Colitis (ACG 2025) - "The patient was started on topical mesalamine suppositories and budesonide foam.The patient was preparing for discharge when he developed distributive shock and was transferred to the intensive care unit. Postoperatively, the patient's shock rapidly resolved and discharged home. To our knowledge, we report the first case of isolated toxic proctitis in a Hartmann's pouch. This case highlights the importance of continuing to consider proctectomy in UC patients with a Hartmann's pouch after TAC for TM who present with systemic toxicity.Figure: Figure 1: axial slices of pelvis computed tomography showing severely dilated rectum.Figure: Figure 2: (A-C) severe inflammation with areas of ulceration and necrotic appearing mucosa seen in the rectum on flexible sigmoidoscopy."

Cytomegalovirus Infection • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis

Curcumin Enema as a Novel Adjunctive Treatment in Distal Ulcerative Colitis (ACG 2025) - "Mild rectal discomfort (13% Group B vs. 10% Group A) and transient bloating (10% Group B) resolved spontaneously. This study demonstrates that combining curcumin enema with mesalamine suppository enhances mucosal healing and symptom control in distal UC. Clinical remission: 60% (18/30) in Group B vs. 36.7% (11/30) in Group A (*p=0.048*).Endoscopic healing: 53.3% (16/30) in Group B vs. 30% (9/30) in Group A (*p=0.041*).Biomarkers: Group B showed greater reductions in fecal calprotectin (Δ=412 μg/g vs."

Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis • IL6 • OCLN • TNFA

Spontaneous Ischemic Proctitis in an Elderly Male on Anticoagulation (ACG 2025) - "We presented a rare case of spontaneous ischemic proctitis in a 95-year-old male on therapeutic anticoagulation.Case Description/ A 95-year-old male with severe aortic stenosis (deferred AVR), CKD stage II, advanced dementia, and recent left lower extremity DVT recently started on apixaban 9 days earlier who presented after a witnessed large-volume melanic stool...In the emergency department he received pRBCs, IV pantoprazole, and Kcentra...Mesalamine suppositories were initiated...Diagnosis requires endoscopy and biopsy for confirmation. Management primarily includes supportive care, hemostasis, and withdrawal of inciting agents with additional mesalamine for potentially symptomatic relief.Figure: Flexible sigmoidoscopy, at the level of the proximal rectum, showing a characteristic "single stripe sign" of ulceration and friability classically seen in ischemic colitis.Figure: Flexible sigmoidoscopy, at the level of the distal rectum, showing worsening..."

Clinical • Alzheimer's Disease • Atherosclerosis • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Dementia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology

Cut It Out! Surgical Resection for a Case of Refractory Segmental Colitis Associated With Diverticulosis (ACG 2025) - "He was started on oral mesalamine and a mesalamine suppository, with minimal relief. A trial of oral budesonide was done with relief of symptoms at a dose of 9 mg daily, but with recurrence once the taper was started...Compared to inflammatory bowel disease, SCAD is a distinct entity with a self-limited disease course without the need for ongoing treatment.Figure: Image 1A-1B: Photomicrograph of colon biopsies demonstrating erosions (arrow A), neutrophils in the crypt lumen (arrow B), architectural distortion (arrow C and D), and neutrophils in the crypt epithelium (arrow E) without basal lymphoplasmacytosis or granulomas. 1C: Colonoscopy image showing severe inflammation in the sigmoid colon."

Clinical • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hypertension • Immunology • Inflammatory Bowel Disease

Recurrent Rectal Strictures in EBV-Associated HLH: A Rare Gastrointestinal Manifestation (ACG 2025) - "This patient had recurrent rectal strictures which required frequent endoscopic balloon dilatation which relieved pain and obstipation.The patient was managed on mesalazine suppository, steroid, tranexamic acid, lidocaine-diltiazem cream, and rituximab.This case emphasizes the diagnostic complexity and highlights the importance of GI symptoms in HLH.Figure: Colonoscopy reveals proliferative strictures with compromised lumen.Figure: Colonoscopy shows Fibrotic stricture seen in rectum at 10 cms from anal verge. Rectum and distal sigmoid colon shows multiple aphthous ulcers and inflamed mucosa."

Anemia • Anorexia • Colorectal Cancer • Constipation • Fatigue • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hemophagocytic lymphohistiocytosis • Immunology • Inflammatory Bowel Disease • Rare Diseases

Development and validation of an in vitro release test (IVRT) method for a locally acting mesalamine suppository. (PubMed, Int J Pharm) - "Moreover, the developed VDC method was reproducible and sensitive in evaluating the in vitrorelease rates of mesalamine rectal suppositories. These data suggest that an IVRT method utilizing a VDC may be used to develop and validate a sensitive and discriminatory method that could ultimately be used to compare release rates between a prospective generic mesalamine suppository and the corresponding RLD as part of a characterization-based BE approach."

Journal • Preclinical

PANCYTOPENIA IN ACTIVE ULCERATIVE COLITIS: AN UNEXPECTED DRUG RELATED ADVERSE EVENT (UEGW 2025) - "She had been on maintenance therapy with oral mesalamine MMX preparation( 4.8 gm/day) and per rectal mesalamine suppository (1 gm/day). Anemia secondary to bone marrow suppression has been reported with baracitinib and udapacitinib , but not with tofacitinib (2). Patients on tofacitinib may also require monitoring for cytopenia and drug doses should be adjusted accordingly.Pre tofacitinibOn tofacitinib 10 mg BDAfter cessationon Tofacinib 5 mg BDHb (g/dL)8.54.97.99.2Total WBC(1000/uL)4200360045708390DLCN-53, L-41, E-6%N55L34E4M7N77L15E2M6N58L28E1M3Platelet count (l000/uL)2.80.640.921.7"

Adverse events • Anemia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Herpes Zoster • Immunology • Infectious Disease • Inflammatory Bowel Disease • Leukopenia • Neutropenia • Respiratory Diseases • Thrombocytopenia • Tuberculosis • Ulcerative Colitis • Varicella Zoster

EFFICACY OF MESALAZINE IN SOLITARY RECTAL ULCER SYNDROME IN CHILDREN: A PROSPECTIVE STUDY (ESPGHAN 2025) - "During this period, they received mesalazine suppositories (20-25 mg/kg/day) and were evaluated every three months.In two cases, oral mesalazine was added at a dose of 50 mg/kg/day for 3 months to enhance treatment efficacy...Conclusions Mesalazine demonstrated significant clinical and endoscopic efficacy in SRUS, achieving rapid symptom resolution and sustained remission.The persistence of symptoms in one patient highlights the potential role of associated factors, such as constipation, in limiting treatment success. These findings support mesalazine as a promising treatment, warranting further investigation in larger cohorts."

Clinical • Anemia • Constipation • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Pain • Pediatrics

Rectal prolapse as a mimic of ulcerative proctitis: A diagnostic challenge (ASCRS 2025) - "Patient Background:• 87 year-old female with ulcerative colitis, scleroderma, CKD, hypothyroidism, HBP, leukopenia, and thrombocytopenia.• Previous surgeries: bilateral hip prosthesis, carpal tunnel syndrome, hysterectomy.• Medications: thyroxine, losartan, mesalazine (discontinued February 2023), mesalazine suppositories.• Allergies: acetaminophen-hydrocodone, dipyrone, hydrocortisone.2. Managing rectal prolapse in elderly patients with ulcerative proctitis requires careful consideration of overall health and comorbidities. The Delorme procedure showed promising results, with significant symptom improvement. Further studies are needed to establish best practices for similar cases, particularly in avoiding radical surgery and managing chronic inflammation effectively."

Chronic Kidney Disease • Constipation • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Gynecology • Hematological Disorders • Immunology • Inflammation • Inflammatory Bowel Disease • Leukopenia • Mucositis • Musculoskeletal Pain • Scleroderma • Systemic Sclerosis • Thrombocytopenia • Ulcerative Colitis

Predicting disease remission in Ulcerative Colitis patients - early results from the PRESAGER study (ECCO-IBD 2025) - "When looking at medications taken within 14 days of inclusion, 66% of patients used mesalazine suppositories and 61% used oral mesalazine or sulfasalazine (Figure 1). Additionally, patients with moderate disease activity had a greater likelihood of remission than those with mild activity, likely due to the increased use of corticosteroids and biologics in these cases. Conclusion Older age and higher disability scores significantly reduced the likelihood of remission for UC patients, while longer disease duration, moderate disease activity, and high calprotectin increased the likelihood."

Clinical • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Medical, Endoscopic, and Surgical Treatments for Rectal Cuffitis in IBD Patients with an Ileal Pouch-Anal Anastomosis: A Narrative Review. (PubMed, Dig Dis Sci) - "Studies evaluating therapies used to treat cuffitis suggest benefit from conventional mesalamine or corticosteroid-based therapies, whereas data regarding advanced therapies and interventional procedures are inconsistent given small sample sizes."

Journal • Review • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis

A Case of Radiation Proctitis With Concern for Immune Checkpoint Inhibitor Colitis (ACG 2024) - "Case Description/ A 69-year-old female with past medical history of recurrent cervical cancer stage III T3 N0 M0 s/p chemoradiation and maintained on carboplatin, paclitaxel, and pembrolizumab, and diverticulosis presented with rectal bleeding...Sucralfate enemas and mesalamine suppositories were started with resolution of bleeding and transition to butyrate enemas as outpatient...Figure: Figure 1. Colonoscopy revealing friability and single ulcer in recto-sigmoid colon"

Checkpoint inhibition • Clinical • Cervical Cancer • Colorectal Cancer • Gastroenterology • Gastrointestinal Disorder • Immunology • Oncology • Solid Tumor

The GIPP Never Lies: A Case of Refractory Ulcerative Colitis (ACG 2024) - "The patient had transitioned to Ustekinumab from Infliximab and started a 40 mg prednisone taper two weeks prior due to refractory UC symptoms...Infectious disease was consulted, and the patient was treated with ampicillin and gentamicin...The patient was discharged on amoxicillin with a continued prednisone taper and mesalamine suppositories without recurrence of symptoms...Listeria monocytogenes should be on a clinician's differential diagnosis of foodborne gastrointestinal pathogens causing refractory inflammatory diarrhea. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024."

Clinical • CNS Disorders • Colorectal Cancer • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Bowel Disease • Pain • Septic Shock • Ulcerative Colitis

Refractory Radiation Proctitis Toolkit: The Usual and Beyond! (ACG 2024) - "Use of compounded sucralfate enemas and mesalamine suppositories have their own value. It's unavailability and cost can be limiting factors. Figure: Persistent and hemorrhagic after 2 sessions of APC"

Anemia • Cardiovascular • CNS Disorders • Dyslipidemia • Genito-urinary Cancer • Hematological Disorders • Hypertension • Oncology • Prostate Cancer • Solid Tumor

SYSTEMIC LUPUS ERYTHEMATOSUS AND INFLAMMATORY BOWEL DISEASE, AN UNUSUAL ASSOCIATION (UEGW 2024) - "Moreover, when both conditions coexist, it usually involves systemic lupus rather than oligosymptomatic forms (2).We present a 20-year-old female patient diagnosed with SLE at age 13 with only joint involvement and well-controlled with methotrexate, hydroxychloroquine and oral prednisone that was referred due to diarrhoea with mucus and blood, diffuse abdominal pain and weight loss...Treatment with oral Mesalamine 3600 mg/day, rectal Mesalamine suppositories and oral corticosteroids led to improved stools, abdominal pain and normalization of inflammatory markers...Management is similar to CD patients, with positive results seen with infliximab in corticosteroid non-responders (3). The coexistence of both diseases presents a diagnostic and therapeutic challenge that requires multidisciplinary management."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Pain • Systemic Lupus Erythematosus • Ulcerative Colitis • Vasculitis

A RARE CAUSE OF A RARE DISEASE: PLEUROPARENCHYMAL FIBROELASTOSIS (CHEST 2024) - "Her medication included prednisolone 2.5 mg/day, cyclophosphamide 50 mg weekly, and mesalazine rectal suppositories. The present case report highlights the rare interstitial pneumonia that occurred in a patient with ulcerative colitis. PPFE is a condition with a highly variable presentation and progression, underscoring the importance of early recognition and a multidisciplinary approach to diagnosis and management."

Bone Marrow Transplantation • Bronchiectasis • Cough • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Interstitial Lung Disease • Pneumonia • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Rheumatology • Ulcerative Colitis

Effects of mesalazine suppository combined with Kangfuxin solution retention enema on inflammatory markers and adverse reactions in patients with active ulcerative colitis. (PubMed, Minerva Gastroenterol (Torino)) - No abstract available

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis

Pyoderma Gangrenosum associated with untreated Ulcerative Colitis complicated with CMV infection (EADV-Sp 2024) - "The patient’s treatment plan included systemic corticosteroids (prednisolone 1mg/kg with gradual dose reduction), mesalazine suppositories, topical wound care and topical corticosteroids (clobetasol propionate) along with intravenous antiviral treatment (Ganciclovir) to eliminate the CMV infection. The case underscores the importance of recognizing the association between PG and UC, as the management of one condition can significantly impact the course of the other. Increased awareness among healthcare professionals about the potential association between PG and UC is crucial. CMV colitis is also common among immunocompromised hosts with inflammatory bowel disease, highlighting the importance of assiduous endoscopic and histopathological evaluation."

Breast Cancer • Cytomegalovirus Infection • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Bowel Disease • Myeloproliferative Neoplasm • Oncology • Pain • Pyoderma Gangrenosum • Ulcerative Colitis