Can missing Mesalamine worsen ulcerative colitis symptoms?

Question

Hi doctor,

I experience pain in the left side of my abdomen that intensifies after eating. I also feel like I am not fully emptying my bowels and often have to rush to the bathroom again within 20 minutes. I often feel weak and tired throughout the day.

I am taking Mesalamine 800 mg three times daily, but I occasionally miss doses. Could this be contributing to my flare-up?
Can missing a few tablets really lead to such a significant worsening of my symptoms?
Additionally, is this level of bleeding dangerous or normal for this condition?

Please help me.

Answer 1

Hi,

Welcome to icliniq.com.

I am deeply concerned about your worries.

Your symptoms suggest an active flare of ulcerative colitis. Passing stool eight to nine times daily with blood and mucus, left-sided abdominal pain, urgency, and the feeling of incomplete evacuation (tenesmus) are typical signs of colon inflammation.

Yes, missing doses of Mesalamine can lead to a flare. This medicine works by controlling inflammation in the colon continuously, so irregular intake decreases the protective effect of the medicine, and symptoms may become exacerbated over time. It is very important that you take it consistently every day as prescribed.

In ulcerative colitis, it is common to pass some blood during a flare, but it is important to not ignore frequent bleeding with weakness and fatigue. The fatigue can be a sign of anaemia from ongoing blood loss or inflammation so blood tests are generally required to check haemoglobin and inflammatory markers.

Your doctor may also adjust treatment during a flare. Options can include higher-dose Mesalamine, rectal Mesalamine enemas or suppositories, or short-term steroids if inflammation is moderate to severe.

In the meantime, you can follow these tips:

Do not miss your medication doses.
Stay well hydrated.
Eat light, low-irritating foods during the flare.
Seek prompt medical review, especially if bleeding continues or you feel increasingly weak.

With proper treatment adjustment, most flares can be brought under control and remission restored.

I hope this helps address your query. Kindly revert with the answers.

Thank you.