Step Up Yay or Nay

Long time lurker, first post.
Thanks to all who share their knowledge.
I could pen a long diatribe detailing my disappointment with two GI practices but what's the point?
I've just experienced three of the worst days of my life. I had diarrhea for five days leading up to a scheduled colonoscopy and post procedure was a nightmare of pain and uncontrollable diarrhea. Things are simmered down but I am at the point of possibly moving to AZA.
My problems started 10 years ago with a case of food poisoning that painfully resolved itself, followed by two episodes of diverticulitis and probably five rounds of cipro/flagyl. I was later diagnosed with UC based upon two seperate biopsies. I later had the Prometheus test that showed the Crohn's marker.
I've been taking 4.8 gr. mesalamine plus assorted supplements (glutamine, qing dai, etc.)
I rarely had the bloody diarrhea that characterizes UC, maybe once or twice, triggering the colonoscopies.
I lost 25 lbs. over a couple years and in the last week lost another 10. 6' 3", 150 lbs.
I've had some days/weeks of relative comfort but usually have some degree of discomfort. Gas can be painful. I have regular low energy. Testosterone is ok.
Having gotten tired of being uncomfortable, the latest colonoscopy was arranged to see what was going on. I'd briefly had some blood but now believe it was hemmorhoidal.
The latest scope showed only minor patchy inflammation. Biopsies showed intact architecture with no significant amount of active inflammation but a conclusion of mild colitis. Doc said come back in three years.

I don't have much appetite and now wonder if that is a result of IBS or chronic low level inflammation. I cannot buy a pound, even when I have managed to eat more. Maybe there's some other absorption issue? I plan to get tested.
My GI doc suggested it was time to step up to AZA or humira. He has not seen the latest scope yet (out of the country, natch).
I'm tired of feeling sickly and must gain weight (I cycle for exercise).
Anyone have mild colitis move to AZA in order to feel better and gain weight? I just wonder if chronic low inflammation is part of the problem. On the other hand, I may be suffering mainly from IBS at this point. However, usually no diarrhea.
If you started in AZA, was the column chromatography 82542 blood test ordered before you started? I told the PA I wanted the TPMT test but I think she does not know what that is. The test ordered looks like it measures AZA metabolites.
That's my story so far. I know I could add enemas if need be but I'd prefer to get deep remission if it will help me gain weight. I figure I could try the AZA and if it does not help, then stop.
My sincerest condolences to all who suffer from this spectrum of disease!

Welcome to the forum.

You could try mesalamine enemas, immunomodulators (azathioprine/imuran), or biologics (remicade/humira). I'd always recommend 1st trying the lower class medications, the mesalamine enemas, before progressing up a class in meds. Enemas are not likely to affect your nightly sleep.

Hard to say whether the lack of appetite is due to inflammation, IBD, or something else. Part of it can be post-traumatic-UC-flare-syndrome. As when we flare it is easy to equate input with output, and have an aversion to food; I know I did. I'd eat less and smaller portions during the flare and that habit continued as I got better. Sometimes you just have to force yourself to eat, and eat enough to regain weight.

Insurance has denied my claim for use of Uceris.
What a crock.