Medication question? Imuran or other medication

hi, i am on Imuran over two years, i have two strictures, but i feel well, with no pain or diahorrea. My recent blood test have showed no inflamation in my bowel, however my MRI have showed the disease is active. Next week i will have GI appointment and i am thinking to discuss with my doctor to change my medication. AnY thoughts ?? What medication would be best to try ?? I cannot really understand, how the disease is active if i don t have any symtons of the disease. I do not know what should i do  to get on remission. Thanks !

Well one definition of remission is an absence of active symptoms, so in that sense you are in remission. That does not mean that inflammatory processes may not still be going on under the radar . . . in most patients they probably are. In your place I would be hesitant to switch meds from something that is working pretty well to the unknown . . . and if you go up the ladder to Remicade for example, you will have shot that bigger bullet at a time you may not really need it. Remember, Crohns is an incurable chronic condition . . . it is very unlikely that you will ever achieve total remission in the sense of no active disease at all. Imuran seems to be working for you, why roll the dice?

I tend to agree with Mike, Krica, except for the following, and it is something you will have to figure out with your physicians.

I see you already have two strictures. Is it possible that the disease activity, while not widespread or acute enough to cause you symptoms, is quietly building scar tissue that will result sooner or later in obstruction from fibrotic stenosis in the strictures? If the disease activity is contributing to the formation of scar tissue then I think you and your GI need to have a frank discussion about the relative merits of getting more aggressive or taking the more moderate course you are now on.

In the meantime, do an honest assessment of your health status, regarding the disease. Are you really symptom-free? That would be great and would be a major factor in weighing your options. But is it possible that over time you have adjusted to the compromises we with simmering crohn's experience? Just because something is bearable, doesn't mean it is normal. Just a thought.

If in fact you are symptom free and your GI is comfortable that you are at a therapeutic level of imuran, like Mike says, it may be best not to tinker with what isn't broken.

Let us know what happens with the GI.