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Imuran for relatively mild symptoms?

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Ulcerative Colitis
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Posted 10/17/2013 5:02 PM (GMT 0)
Hi, first post in the forum, been a lurker for a while

So I was diagnosed in July with mild patchy colitis affecting my entire colon. I never really got severe symptoms:
At most using bathroom 5 times in a day
Some D and only blood and mucus a few times
Bloating and some discomfort.

I got put on Asacol but that didn't really change anything so went on Pred 40mg and started taper. Since coming to around 20mg and lower I have seen bloody mucus in my stool 3-4 times but my stool is really well formed, only going 2-3 times a day.

My Gastro is pushing to go on Imuran and is telling me I'm steroid-dependant. I wondering if trying something like enemas maybe be better at this stage as my symptoms aren't too severe and it may only be the last bit of inflammation in the sigmoid/rectum that needs dealing with. I'm very conscious of the side affects of imuran and wouldn't want to go on it unless really necessary.

Any replies would be great

:-)
Posted 10/17/2013 5:29 PM (GMT 0)
I hate the thought of Imuran myself and have refused to go down that route since I don't do so badly either. To use the strategy you describe you should have some kind of evidence that your hypothesis is correct in that "it may only be the last bit of inflammation in the sigmoid/rectum that needs dealing with". If that is true then that's not a bad gameplan (if the Asacol is working) but you also stated that you were "diagnosed in July with mild patchy colitis affecting my entire colon" and that "I got put on Asacol but that didn't really change anything". If that is true then your hypothesis may not be correct and your entire colon may still be effected, parts of which will be out of the reach of enemas. Pretty much everyone is "steroid-dependant" unless you can find a maintenance therapy that will keep you in remission once the prednisone is tapered off. Imuran can take several months go kick in so if that is the road you are eventually going to go down then it would be best to start ASAP, although I can certainly understand your hesitantcy.
Posted 10/17/2013 5:35 PM (GMT 0)
i would definitely try imuran if i were you. if you are prednisone dependent, then you need something to take over when it's done. since your whole colon is involved, i wouldn't count on just using enemas to make it better.

if you find that imuran isn't helping or giving you side effects, you can always stop. that's the one good thing about medicine.
Posted 10/17/2013 5:50 PM (GMT 0)
Thanks for the replies guys, really appreciate it.

I think I'll mention enemas to my GI and see what response I get. If I do end up taking the Imuran route, do you think I could get away with letting it build up in my system without using Pred at the same time? because to be honest I kind of prefer my mild symptoms to the Pred side effects.

Cheers
Posted 10/17/2013 5:56 PM (GMT 0)
Sorry, if you are pred dependent then, yes, you must stay on pred until the Imuran builds up in your system. It takes a couple months for Imuran to build up enough in your system to be therapeutic. Be patient. I've been on 6mp (very similar to Imuran but metabolized differently in the body) and I have had no symptoms from it. I haven't been sick any more than before either (despite it being an immunosuppressant). I hope it works well for you!
Posted 10/17/2013 6:47 PM (GMT 0)
i agree with ipoop. you need to start imuran before you get off prednisone. i started both in july and am still waiting for imuran to work. i tried to get off prednisone two weeks ago and bloody diarrhea started again.
Posted 10/17/2013 7:12 PM (GMT 0)
Why did you get on pred so quickly? Why not 5asa? Sorry you are in between this rock and hard place! I would be so mad with dr to get you here so fast if you are not all that bad. My dr tried pred on me and I quit it after 4-5 days!

Not saying I won't ever need it but I can't see taking something that toxic just to have the trouble come back when u get off it!

I am doing rectal stretoids, not so bad.
Posted 10/17/2013 7:13 PM (GMT 0)
Agree with ipoop too. To get the full effect of Imuran, it can take 3-6 months. I'm currently on both pred and imuran, just starting to taper off the pred. But I am also on remicade and asacol.
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