ubereem,
I understand your being overwhelmed. UC sucks and it's a difficult disease to live with, manage, and have some quality of life.
I think you're doing the right thing: LDN + Imuran, and when you get some decrease in symptoms you'll be able to wean yourself off the Imuran very slowly.
I look at UC - as having many causes - IMO, for some of us it's bacterial induced, and for some of us it's stress induced, and then for others it's a combination of the two, it's really so hard to tell. And frankly, at this point, since we have this ugly disease, what difference does it make? Knowing its cause will not reverse the clock, unless you have a time machine?
Personally I believe it's very important to treat UC multi-factorially (is that a word, lol?): through diet, supplements, and yes, LDN. The whole purpose of diet is to get the inflammation down - and that's why I believe in PALEO diet as the best, as it is anti-inflammatory. The supplements help with insuffiency of nutrients, and act as complementary to the diet and LDN. There are reasons for each supplement: good and strong Vit. D3 levels are crucial for a multitude of reasons (there are many studies linking low d3 levels to IBD). L-glutamine powder is for long term colonic repair, and short term can help with D, slippery elm powder is great because it coates the whole alimentary canal, and IMO it is nature's equivalent to the mesalamines. Probiotics are key in helping with gut flora. I use VSL#3 because it has been especially formulated for UC with 450 Billion active cultures, and I also take with it S. boulaardi as well. And then of course, there's LDN. That's what made the huge difference for me. I was on SCD at the time I started LDN, bleeding heavily every day (ongoing from 1 1/2 years), and it stopped the bleeding after 7 days of transdermal LDN. To me, that was miraculous because nothing else achieved that for me. Slowly, within the last 6 months, I've come around to a truly Paleo diet - I eat mostly grass-fed meats, fish, salads, veggies, and some low sucrose fruits, BUT no grains, no carbs at all.
Here's what's worked for me in more detail:
1) Diet is key for me: I do the Paleo diet, and I am very, very careful with food combining, because if you mis-combine it creates havoc! Here's some info on it: http://cureforulcerativecolitis.com/step-1-methodology-to-eating
2) Adding L-Glutamine powder 5-10 grams daily - for colonic repair. If you're having issues with urgency and diarrhea, then you'll need to take L-Glutamine powder 1 teaspoon mixed in a little water on an empty stomach, and that should alleviate your symptoms alot.
3) Adding slippery elm bark powder - 1 tablespoon mixed in a little water, 3-4 times a day - IMO it is the equivalent in nature to the 5asa's and works much more effectively than all the mesalamines without the side effects.
4) Probiotics are key. If you can get your doc to write you a prescription for VSL#3 DS - that would be better, stronger, and probably cheaper ( IMO 3 x per day at least) than buying VSL#3.
5) Drink lots of good water.
6) Get your vit. d and b12 blood work done, to see if you are deficient.
7) SCD diet - specific carbohydrate diet - many have had lots of success with it. If you can't do it because it's so strict, at the very least do dairy free, wheat free, gluten free. Personally, however I prefer the Paleo diet, because it is an anti-inflammatory diet - mostly veggies, salads,nuts, fish, lots of GRASS-fed animal products like lamb, beef, bison, and eggs, no grains at all. The whole basis of the diet is to concentrate on foods rich in healthy ratio of omega 3 to omega 6, which is ideally 1:1. Grain-fed animal products contain unhealthy ratio of 1:20 which causes and contributes to inflammation in the body, and therefore disease. Also grass-fed animal products contain important CLA, which you cannot get from any other source.
8) start a food journal and see what correlations come forth
9) There's a great app for keeping track of your symptoms, diet, meds, etc...
http://wellapps.com/products
10) Do some research on LDN - low dose naltrexone, you can search this forum as they are several threads on this. I can tell you it works!
Here's the Penn State research done by Dr. Jill Smith with LDN and Crohns Patients.
http://www.ncbi.nlm.nih.gov/pubmed/21380937
https://www.healingwell.com/community/default.aspx?f=38&m=2204683#m2222188, https://www.healingwell.com/community/default.aspx?f=38&m=2129791&p=1
11) Since you are intolerant of mesalamines, which would probably include the enemas and suppositories, what about Butyrate enemas?
12) You may want to add liquid vitamins/minerals to make sure your stomach does not have to do the work of breaking them down, and hence not absorbing them.
13) Also, I've been supplementing with good quality whey protein - Dr. Mercola's Pro-Optimal Whey, which I make with almond milk ( you can see from my sig).
14) Astaxanthin is a great anti-inflammatory
What do you think?
Good luck, and I hope you start to feel better soon.
Let us know how we can help you.