Why would GI say that?

Ok, mentioned in other post that I seen my GI on 15th and he said my meds (4 x Pentasa, 15mg Pred) weren't working (going to toilet 4 x day, D, blood 1 in 3 movements, lots pain/wind/no control). He took me off Pentasa (a week to see if urgency & D got better), and put me on azathioprine (Imuran).

Well, a week later and I've been going to toilet around 6 times a day, blood pretty much every time, still pain/no control.
I phonmed the IBD nurse yesterday who told me she'd speak to consultant 1st thing this morning and phone me back. She also told me to start on the enemas (Salofalk Mesalasine) again.

The IBD nurse phoned me and said the consultant said to go back up to 25mg Pred, if no improvement by w/end 30mg. I've to phone again on Monday morning to check how I am.

The strange thing is the IBD nurse said consultant specifically said NOT to use the enemas. Anyone know why that would be?

(That aside, hope the increase in Pred' gets this under control )

To be honest I feel pretty down about it all. I was diagnosed in Nov and it's never got better. It's also got markedly worse over last few weeks, hence the azathioprine, which I really didn't want to go on.
I can feel (and see objectively) that it's getting worse. The increase in bleeding is back like it was several weeks ago.
I really like the GI and has a lot of time for my questions (all the nurses speak highly of him as well) I feel he genuinely is concerned for my well being.
From the meeting on the 15th he certainly said he was concerned how the disease was going and that we need to get it under control, which it isn't so far.
I'll have to ask him what his plan is!

Thanks. I like the sound of your GI, mine told me 12 weeks!

I agree with pb4 about the steroid enema. Get the 'roids to the point where they're needed most - treat BOTH ends like Quincy's doc says.

Imuran can take 2-3 months (on average) to kick in - hence sticking with the pred to help control symptoms during that time.

My last GI would tell me his plan straight out. It sure helped me (mentally/emotionally) to know what that plan was. So definitely ask your doc!

SC...it's awesome you like and respect your GI and that he takes the time for you.

I like the idea to ask the doc about the plan. He clearly has one, but it's offered you more confusion than comfort.

Do make a list of some questions regarding meds, why, what now and what then? for when you see him next.

I saw my doc a lot the first two years.  I was only on 5ASA oral/rectal meds, but him taking the time to explain and to reassure me went a very long way. 

quincy

My GI explained to me that taking an oral 5-ASA will treat only so far down into the colon while the rectal meds will treat from the bottom up to so far. I have left sided extending to the upper bend of the colon (forgot what that was called), so the problem that I was having is that the oral med wasn't reaching to above the sigmoid and neither was the rectal meds. I always had that small portion that was ulcerated. But I think that my going on an rectal med that it can offer some relief to the rectum/sigmoid area.

makes sense....considering you're also on pred..which could maybe mask some symptoms or results.

Thanks so much for the information SC..good to know.

But, there are also steroid enemas..still something he could offer you.
q