treatment advice--hold off on humira?

Thanks to all for your support as always.

I am scheduled to get my vaccines today before beginning Humira next week and would love some counsel about next steps in my treatment.

The flare I'm in started in mid-August and is the worst I've ever had. At the end of September I did one week of prednisone at 30 mg, then stopped and switched to Uceris, all the while still taking Asacol HD, which had kept me in remission for six years. I got worse on the Uceris. I relented to my GI and started prednisone again. I took 60 mg for ten days and then tapered down to 40 mg last Friday. After having nothing but liquid diarrhea for what seemed like forever, I got formed stool that day I tapered down to 40 mg. I also stopped the Asacol at that time to see if that was contributing to the diarrhea.

Overall on the prednisone WAY fewer trips to the toilet (3 a day), less urgency, etc., but the only time on the prednisone I saw no blood at all was 60 mg.

Since last Friday, I have passed what I call pellet poops with a little bit of blood and mucous. Just a few at a time, but I feel like they are in the neighborhood of what poop used to look like for me. I took a mesalamine enema last night and was able to retain it until morning, which was also an improvement over not being able to retain rectals at all.

Are pellet poops progress enough that I could try another week of the 40 mg of prednisone and reintroduce Asacol HD to see if I can get where I need to be without the Humira, even though I'm seeing blood and mucous? The only other time in my life I've taken prednisone was that flare six years ago, and I was on it for about four or five months. That plus the Asacol HD got me into remission. As of today I am at two weeks on prednisone. I fear the effects of prednisone greatly, of course, and I also fear the effects of/dependency on biologics, so that's why I'm uncertain what to do.

I'm 47 and have had UC since I was 20.

Thanks for any thoughts. I know people have varying opinions but I appreciate hearing them all.

Post Edited (fadoozle) : 11/9/2017 6:25:45 AM (GMT-7)

I had a mild flare earlier this year and tried to stick with just Lialda/Rowasa instead of moving to a biologic or re-starting Imuran. After a few weeks on steroids and a scope, my GI agreed to try it. Flared with severe pancolitis in September. If I could do it again, I’d go to stronger meds sooner. I’m on everything now and was a step away from hospitalization...it’s been a long slow crawl to feeling better.