Azathioprine should I take it? Ulcerative Collitis

Hi All,

I was diagnosed with UC last year, however last week after another colonoscopy they have confirmed my entire colon has now being affected with inflammation. I was on predisvolone steriods for one month and asacol twice a day.

I am still going to the loo about 10-12 times a day.. struggling to get one with my daily life. they have told me the next step is Azathioprine.. I am terrified to take it. has anyone rejected this drug and persevered with the pain?

Yes, I would recommend taking Azathioprine in your situation.

What, exactly, terrifies you about this medication? I've been on 6MP, a sister medication to azathioprine, now for 4 years and have experienced zero side effects from it.

We're all a little worried when starting a new class of medications, myself included. What helped me was to look at the actual odds of risks and benefits. There's about 70 percent odds that aza will improve your UC symptoms. The odds of side effects are very small. The benefits far outweigh the risks. If you want to take a deeper dive into it, see The Crohn's and Colitis Foundation of America resources:
Webcast: programs.rmei.com/CCFA139VL/presentation/player.html
Transcript: http://www.ccfa.org/assets/pdfs/risk-and-benefits-transcript.pdf

75% of UC patients do not need surgery, so the odds are in your favor of not needing a surgery, yourself. Taking stronger medications doesn't at all make us more likely to need a surgery! Actually it's the complete opposite, if you respond very well and enter into a remission thanks to Aza then your odds of needed a surgery are greatly, greatly reduced. It's when our flare is so severe that we do not respond to anything that surgery becomes likely. To that end, you're much better to treat your flare aggressively with whatever medications are necessary to do so, to control your UC and regain a remission. Best to extinguish a fire early and quickly, before it becomes a completely out of control wild fire (and the same goes for UC flares, catch them as early as possible, hit them hard with aggressive treatment and avoid the worst of symptoms and pain).

None of us know whether we will ultimately need a surgery, but again, the odds are certainly against it. But is surgery really all that awful of a thought? I think of being rid of UC once and for all to be a very calming thought. I mean think about no more uncertainty of random flares popping up and ruining a vacation, no worries about sudden accidents due to extreme UC urgency, no more flare pains from UC, no more suffering and reduced quality of life. If my UC ever becomes uncontrollable, and all medications fail me then I'll gladly have surgery to be done with UC once and for all. I've whimsically thought, that I'd have the surgeon give me the large intestine afterwards, so I could burn it and my former meds in a fire with great hedonistic enjoyment (music, booze, dance) as a grand celebration to be rid of the former pain within my butt haha.

since the last month and half I have been going to the toliet over 10 times a day sometimes slightly less. within the last 2 weeks I have been waking up every 3 hours to go to toliet. since June this year I have been bleeding heavily with cramps and burning sensation in my stomach. I was given 40mg steroids which were reduced every 10 days for a month and asacol twice a day. my symptoms didn't really reduce much.. i am on 20mg now and my toliet frequrncy hasnt changed. is it safe to say I have a severe flare up and need the aza to try and get back to remission??

sorry for asking too many questions. I just feel so lost.

I was scared to death when the doctor suggested azathioprine for my then 16 year old son. He has now been on it for over 10 years and it has been amazing for him (along with Lialda). Since being on it in 2007, he has had a flare in 2009, 2011 and that is pretty much it.

My daughter has been on the similar drug called 6mp (mercaptopurine) also for over 10 years with even better results than my son.

I know how scary it can be to consider those drugs but they have been around for a very long time and people with cancer or organ transplants take even higher doses than those with IBD.

thank you everyone for your comments and welcoming me to the forum.