There are two schools of thought right now among gastroenterologists about
how to treat Crohns. The "step up" school follows the more traditional path of beginning with the lower level drugs and moving up until you hit a medication that works . . . basically starting with the ASA/mesalamine drugs like Pentasa, then 6mp/Imuran immunosuppressants and then on to the biologics. The "top down" theory says start with the big biologic guns because otherwise you run a risk of the disease doing more damage (like fistulas or strictures that cna lead to surgery) while you piddle around with the less forceful drugs. The problem with that, in my view, is that not everyone has severe fistulizing or stricturing disease . . . and that there is a disturbing number of people who find that the biologics lose effect after a period of time. Remember you are in charge of your illness. If you prefer to begin with 6mp (or even stay with Pentasa for a time) and see if that works for you, you can insist on that. There is always time to move on to Remicaid or Humira later. you say you are 23, so it is not likely that your disease has done a huge amount of damage to this point. If thetre are no signs of fistulizing or stricturing disease, I would say you can afford six months of trial therapy with 6mp as an example before jumping right onto the Remicaid merry-go-round.