new GI/reality check and 10 year mark

So many things to address since my meeting with my new GI today. I ll start with the main one. I've been in remission for 5 plus years, taking imuran and colozal and feeling great, currently no symptoms. New doc is closer to my town and I decided to check him out as my current doc is nearing retirement and an hour drive from my home.

New doc is agressive compared to my current doc and took my breath away when he started discussing mucosal healing as being the absolute marker of health. Three years ago my disease was not active but my colonoscopy showed inflamed mucosa. According to new doc if there is not complete mucosal healing at my next colonoscopy (schedule end of May) then we need to do what it takes to achieve this, ie Humira/remicade since I am maxed out at the imuran levels for my weight. Then he said if I have a 'burned out' colon, a colon that has plateaued and not able to get the mucosa healing that is deemed healthy then I might want to consider surgery. I had currently not really been thinking about my UC very much except that I need to take pills and see my doc every three months and have a colonoscopy every 3 years. I was hideously sick and have gotten to this place where it doesn't rule my life, was feeling optimistic that I could maybe even come off the Imuran but now suddenly a doc is talking surgery. I know that part of this involves the length of the disease..I am approaching the ten year mark. He strongly recommends yearly colonoscopies from this point out since reaching year 10, due to the cancer threat.

Please offer your thoughts. I am not ignorant about this disease...I know it's realities, intimately. Maybe I have just had my head in the sand. Feeling a bit rattled tonight. I do plan on meeting with my previous doc with this new info (he's treated me well and understood my visit to new doc) but wanted a bit of input particularly from the veterans on here.

Doctors are trained to look at physical manifestations of UC and (somewhat) disregard what our symptoms are. You should take what he's saying seriously but apply that information through the filter of what you want to do.

He does not want you to get cancer. Check. But ask him: what are your statistical chances of that?
If you do yearly c-scopes IMO you are safe from life-threatening colon cancer because it grows slowly.

My opinion FWIW is that chances of getting cancer vs. using Remicade would = I'll take my chances with not using Remicade.

Telling you surgery is the alternative to Remicade is out of proportion to what your current condition is. However if you deteriorated suddenly it's helpful for you to know what you'd choose, so that in the middle of a crisis you have made that decision in advance.

If it were me I'd try and work on mucosal healing using foods and supplements. He is right that just because you feel fine with no symptoms does not mean your colon is healthy. Use this information (inflamed mucosa) and get to work. You Rx meds are keeping your symptoms at bay but your colon needs help.

There are many threads on this: resistant starch, butyrate foods and supplements, etc. Do a search.
I got my inflammation down with diet mod. because I wasn't as lucky as you with meds.

Thanks you for your response. I feel like the mucosa healing vs symptom-free is a new challenge that I need to delve into and research. @imgardener2 Any specific sites or links you would recommend?

Personally I think you're new doc is far too aggressive. You are doing better than most and he's talking about Humira, Remicade, and surgery? There can be nasty side effects to the meds so I think it is foolish to take even more nasty meds when you yourself seem to think that you're doing quite well. I do agree with yearly colonoscopies from this point on. If it were me I would pick out another doc. I believe the degree of colon damage is reflected in your symptoms. If you're doing good you're doing good. Don't let the doc convince you you're not. Most of us here would trade our symptoms for yours.