.Gut toxicity of 5-ASA?

The use of enteric coated 5-ASA is contraindicated in the presence of active peptic ulceration. The basis for this is unclear. The author wished to ensure that this drug was not toxic to the gastroduodenal mucosa before proceeding with a clinical trial of a suspension of 5-ASA in the treatment of proximal Crohn's disease. A review of the literature indicated that 5-ASA protects against ischemia/reperfusion-induced damage in the rat stomach but not against ethanol-induced injury. Studies in dogs indicated that 5-ASA does not cause gastric or duodenal damage. Similarly 5-ASA did not delay gastric ulcer healing in the rat and did not inhibit gastric tissue culture synthesis of prostaglandin E₂. The current findings suggest that there is no contraindication to the use of 5-ASA in proximal Crohn's disease.