Any advice?

good question.... i always seem to get a teeny bit better the first week or 2 of pred then go back to square one and it does nothign for me.
so far it seems that no meds do anything for me.
i was in a flare for year and half on eveyrthing you can think of and nothing worked. then one day it was gone completely.
now 6 months later, its back. darn it!!!!
and no meds are doing anything for me.
of course i will stay on them and see what happens. but, it seems im getting worse, not better.
and of course, feeling like crap and not getting better puts one in a crap mood which in turns makes everything crap. viscous circle.

Welcome to HealingWell, Disbooner.

There are several differences in UC and Crohn's. As you pointed out, UC is limited to the colon while Crohn's can affect any part of the GI tract. Another difference is that UC is almost always continuous, meaning the inflammation starts at point A and ends at point B and there is no uninvolved area between. In Crohn's, there may be patchy areas affected with healthy tissue between. A third difference is that UC affects only the innermost layer of the intestinal wall. Crohn's can affect the whole thickness of the intestinal wall; thus the much higher incidence of fistulas in Crohn's disease.

Regarding your symptoms, give the Asacol a couple of weeks. If you're still worse at that point, call your GI. Some of us are unable to tolerate Asacol and will get increased diarrhea and cramping with it. Usually we are able to tolerate other sorts of 5-ASA's such as Balsalazide.

Some people have indeterminate IBD, which means they have some features of Crohn's and some of UC. Generally speaking, the colonoscopy and biopsy findings are more reliable for diagnosis than the Promethius test.

You should also be aware that if it's crohn's-colitis (CD affecting the colon) that the same meds are used to treat it as used for UC.

Regardless of which you have, fibre supplementation and a good probiotic are essentially a must for IBDers and I'd be strongly considering changing my diet...that's what I did, no more fast-foods, processed foods, animal fats, caffeine and refined sugar, sugar substitutes/artificial sweetners as these can all exacerbate IBD symptoms...exercising to the best of your abitlity is also highly recommended, just ajust it accordingly to how active your disease is, but something is always better than nothing, not just for the body but for the mind as well.

:)