Prednisone is an awful drug to be on, but it is very effective at clearing up symptoms, so it can be a pretty powerful tool. If you want to read all about
my take on it, check out my blog post "Dread of Pred" (link below). I don't want to scare you off with what I talk about
in there, but you need to be prepared for what to expect if you're going to go on it.
Dread of Pred: ronnielee-fightingforit.blogspot.com/2012_03_01_archive.html If your UC is left-sided and limited to the bottom portion of your colon (rectum/sigmoid) as you say in your signature line, then I would HIGHLY suggest trying Cortifoam (hydrocortisone foam) first. It is the same steroid drug but in topical form - as a rectal foam you squirt up there once or twice a day. It is much easier to retain than an enema - you don't even really feel it once it's up there - and it will not give you any of the side-effects of prednisone since it is not systemic, but it will be just as effective as prednisone if not more so. (As long as it is reaching all your areas of inflammation.)
I wouldn't jump to 6mp or other biologics right away since it is a pretty intense drug and can have some pretty serious side-effects. Definitely worth it if your disease is severe or if nothing else works, but if I were you I'd try other things first. Also, with immunosuppressants and biologics, once you go on them and then off of them, they can be less effective each time you try them because your body develops antibodies to them - so usually the docs say once you're on them you should stay on them indefinitely. Not a door you want to go through lightly.
Definitely check out probiotics - VSL3 is like the mother of all probiotics and has been reported to work wonders for some people, especially the double strength version, but it is quite expensive. You need a prescript
ion for the double strength though, so maybe if you get a script
your insurance can cover it? Personally I would always just go to the pharmacy, read the backs of all the bottles, and get whichever one had the most strains.
You should also look into the different diet modifications out there if that is something you think you could tolerate in your life. The docs won't tell you much about
that - in fact a lot of them actively say that diet does not play a role - but many people here will tell you the opposite. For many of us, cutting out certain foods can eliminate or drastically reduce symptoms. The tough part is that different diets work for different people, so it is sort of a trial-and-error game until you find what works for you. If you decide to go this route, start keeping a food/symptom journal so you can see what foods are causing problems. Check out Specific Carbohydrate Diet, paleo diet, FODMAPS, and elimination diets... there are others, but I can't think of them off the top of my head. The Specific Carb Diet is the one that seems to be most successful for people with UC. However, you may not even need to go that drastic - for some people it's as simple as eliminating dairy and/or wheat, which is what I would try first.
I would also look into adding other nutritional supplements to your regimen - there are tons out there that are said to be helpful for UC. L-Glutamine, pure aloe, licorice root, slippery elm... Do a google search for it and you'll come across a bunch. Also look into psyllium husk/seeds and chia seeds.
There is also LDN (low-dose naltrexone), Wellbutrin, tobacco, medical cannabis, fecal transplant.... the list goes on.
Anyway, if there is one thing to know for sure about
UC, it is that there are a million and one different treatments out there, and they all work differently for different people. No one treatment works for everyone, so you just have to experiment until you find a combo that works for you. It can be very overwhelming at first, and if I were you I'd start keeping a journal about
different treatments you've tried and how you reacted to each. As you research, make a big list of the things you want to try. Then go through the list one thing at a time, recording your doseage, frequency, symptoms, side-effects, reactions, etc. I wish I'd started a journal like this in my early days, because after a few years it can be hard to remember how well different things worked or why you stopped trying it or whatever.
Hope I didn't make things worse by throwing too much out there, but just wanted to let you know that there are many things you can try before going to the "hard" drugs. Good luck with everything!!