Are my starting meds too strong?

I don't think so. I think doctors are sort of changing their thinking from starting from the bottom up and moving more towards starting stronger from the beginning.

I mean, let's be honest-I don't want to be taking the Pentasa I take, much less the immune suppressors, but it is what it is. Your entire colon is inflamed, so...

Hopefully you can establish a good long solid remission and back of the Imuran in the future.

I would want rectal meds if I were you. They only reach 1/2 or a little less than half of the colon, but you are getting medicine there directly. I have Crohn's and I still use them.

Yes, he should have started you off on 5ASA's first. I would shoot for Lialda.

As Levi said there are two schools of thought in regard to this with GIs:

1.) The old school way of doing this is start with the oral and rectal based meslamines (Asacol HD, Lialda, etc.), reassess after weeks or months and add in immunosurpressants (imuran, 6mp, aza) if the patient isn't responding, wait and add biologics (remicade, humira, etc.), if no response to drugs then surgery.

2.) More recently, some GIs are starting patients with biologics or immunosurpressents right out of the gate.

In your situation, it'll take several months for the Imuran to build up to therapeutic dosages in your body. So, you should remain on prednisone until that milestone has been reached. If you get off of pred too quickly, before Imuran is in full-effect, then you will relapse and go back into a flareup. Pred is a crutch to help you until the Imuran fully kicks in. Pred is a temporary measure, and once you get off of pred, your other medications need to be enough to keep your uc in check.

How much do you weigh? 50mgs of Imuran is a very low dosage.

Shoogashayy, my receipt from the pharmacy says $439.99 for 28 dosages of the generic Rowasa enema. I use them nightly.

I would inquire about generic Rowasa. I use Perrigo. There is one from Teva pharmaceuticals but I THINK it's no longer available.

I would worry more about whether they are working than on 5-asa vs Imuran. You can discuss 5-asa as maintenance med if Imuran works.

I have Sulfa allergy and inflammation through entire colon.
I started with Lialda but it did not work.

Im on balsalazide now, with some relief.

I wish my doctors were more aggressive , like yours. I've been in flare since June and my doc just kinda shrugged that i had been bleeding for 5 months and lost 25 lbs. Lol.

Id def take aggressive over apathetic.

I think your dr is taking a good approach. I had inflammation throughout my entire colon at my initial UC diagnosis and my GI at the time gave me asocol. It did nothing. Then We went thru all the other 5asas. I just kept getting worse. I needed something stronger and I didn't get the help I needed for a long time. Boy what I know now that I didn't know then! When you have inflammation thru the entire colon, it's a whole other ball game and it needs to get in check sooner rather than later. Good luck!

Still on my first rx of azathioprine so it hasn't started to work yet. Just waiting for some relief. Predisone has helped with bleeding and my urgency is better. Idk if it's either one working but I still am very fatigued and don't feel well

Thank you so much, we're u able to taper off prednisone ok with imuran?