Steroids or Imuran- which should I choose?!

I'm back :(

I was diagnosed with UC (mainly proctitis) about 2 or 3 years ago. I was in remission for a little while and came off all meds. Then it returned a few months later and those meds no longer work! I've tried pretty much everything but last week my consultant said I need to go on either Imuran long-term or oral steroids for at least 8 weeks, because the ulceration and bleeding are now acute. The thought of either one scares the cr*p out of me (No pun intended!).
Basically my only symptom right now is bleeding, it's every day - with or without BMs, it's heavy, pretty much all of my clothes and bedding have been blood-stained (despite using panty-liners). Yes, it's gross and embarrassing but is it worth taking really strong drugs with nasty side-effects?!

I'm in my 20s and I've accepted that my life can't be "normal" with this illness but having severe side-effects will depress me!

Any advice is appreciated :)

My current meds (not working) are Dipentum, Predfoam and Cymbalta

I agree. Most GI's put you on Prednisone for at least a couple of months when you start Imuran because it isn't effective right away. I'm also wondering why your doctor isn't talking about a different 5ASA drug such as Pentasa and Colazal along with mesalamine enemas. I think I'd ask to try Colazal and the enemas before going on either.

I agree with princesscolon. I am also surprised they don't start you on pred to get the bleeding stopped and the ullcers healed and then get you on Imuran. Judy

Two different animules, pred and Imuran. One is supposed to be a short-term fix, one is a long-term fix. You probably need to go on both for a short while, then hopefully you can get off the pred after a couple of months.

I've been on Imuran for around six years. It's worked wonders for me! And, like most folks here, I hate the pred. It's a necessary evil, however, in some circumstances. :-(

Mitz

PMH, the medications help to maintain remission and prevent colon cancer. We do see people who go off the medications, but sooner or later the flare comes back and sometimes it's less easy to control then. It's up to you, of course, but as for myself, I'll keep taking my maintenance meds.

I am not a gambler. My meds will hopefully give me a longer term remission. I will stay on my meds. Imuran is to help give us a better chance of staying in remission, but like life nothing is 100% guaranteed. Judy

Pb4 -
I came off meds altogether because it was considered that I had a very mild case of UC and therefore just trying to relax and changing my diet was supposed to be all I should do.
Unfortunately although it's in a small area it's not at all mild, my new doc says it's severe. I've had daily bleeding (and lots of embarrassing leakage of blood) for 8 months straight now!

Keith (ks1905) -
I don't think Remicade is used here (in Ireland). Apparently we're the second richest state in the world but have one of the worst healthcare systems!
Some of my friends are GPs (general physicians?) and they said that combining oral steroids with Imuran is considered too harsh.

I'm going to suggest to my consultant (GI) that I take oral steroids for a few weeks combined with Pred retention enemas to see if that can stem the bleeding. I may end up bloated and single though ;-)

PS Why does everyone hate Pred? Is it 'cause of weight-gain and mood swings?

Ooooh, that doesn't sound like fun! Thanks again, I think I'll be on pred for at least a few weeks though. Gotta do something :-(

Suesse - I do not hate Prednisone. I have used it each time I've flared (4 times total over many years), and it has worked every time. I have never needed to be on it for more than a short, 8 week taper. I really do not experience many of the side effects, other than some insomnia during the first week or two and the occasional hot flash. I have never had moon face, hair loss, mental lapses or mood swings from it. I have had three bone density tests and have not experienced any bone loss from Prednisone use. There are some of us who tolerate it quite well.

Because the Prednisone has the ability to push me right into remission (literally, within days of starting it), I prefer it for my flares. The Asacol and Rowasa I use on a daily basis keep me in remission during the interim (typically, years in between flares). Until I get to the point where the mesalamine products are not working anymore and/or I become steroid dependent, I will not consider the harsher immunosuppresant drugs (i.e. 6-mp, Remicade, etc.).

I'm sure there are going to be people who disagree with me, but I just wanted to offer you a different perspective on short-term Prednisone use versus long-term use of immunosuppresants.