Imuran

Hi, this is my first post on this site. I am a 45 year old man. I was diagnosed with proctitis in 2001, went into remission without any western meds (used Ayurveda, Chinese meds and psyllium). In 2003 I had a severe flare and was diagnosed with UC, did a course of pred, went into remission and was on Asacol and in full remission until early this year. did a short pred course went into remission for two months and then started bleeding again in end of April. I have been bleeding and putting out mucous since then. with diet -lately mostly chicken/fish and cooked veggies, minimal starch plus psyllium and glutamine the flare is lessening. I am managing ok, but I think if I could just get back into remission I might be able to manage to stay in it (with dietary care). MY doc wants me on Imuran for the rest of my life, I am not ready for that. I am thinking that all of the previous flares I just mentioned, I can trace to dietary carelessness...but dietary care is not seeming to get me back into bloodless and mucousless stools. I am wondering what people think about Imuran, dangers and benefits? also what do people think about my theory that perhaps a rectally administered steroid/ short term could do the trick to get me back into remission?
Thanks for any help and comraderie you can offer.

UP 2001
UC 2003 Pred taper
Now in flare most of 2009, on Apriso (another Mesalamine prod), cave man diet, psyllium, glutamine

Well, I can't advise you too much on a diet, since I eat starches in a flare but they don't seem to help you.

I'm all for trying out a rectal steroid, especially if you have proctitis or even sigmoidwhatever. Probably an enema, or that along with a suppository, I'm not an expert on rectal meds (yet!).

I will tell you about my experience with Imuran though. I do agree with songlady, the risks from it for UCers are lower than what you will probably see. You might see something about a lymphoma risk, that is generally for those taking Imuran for organ transplants as they are on much higher doses. Personally, Imuran has done nothing but good for me! No side-effects, not even fatigue. I love it, others don't. I think people think it's worse than it really is a lot of times (although for some it's not a picnic, I'll admit).

If you think you can control this with diet, by all means, go for it. But you may need a bit of help to get into remission first. Rectal meds are defiitely an option or maybe you could up the Apriso.

I don't think doctors normally turn to sulfas anymore (I think that's what they are), but maybe you could ask about that? I know some people have long remissions with those.

Good luck, sorry for the novel lol

Hello, I have been on Imuran for about 6 years now ( I think, maybe longer). I have seen no
unwanted side effects since starting its use. I visit my GI every 3 months and have
bloodwork done at the same time and have not had any noticeable changes in my liver panel.
Keep in mind that what works for one may not work for another. Everybody responds
differently to medication. Good luck.


Later...

Great!
They have a LOT less side effects that oral steroids (i.e. prednisone) but some steroid does seep into one's system with the enemas so.... they're not best used for maintenance. Once you get off them, the mesalamine enemas are good for maintenance, and I believe that, used even twice weekly, the mesalamine enemas are thought to help reduce the cancer risk that otherwise increases over time.

Re. the steroid enemas, in a normal course I am on them about a month of every night.....then about a week or 10 days after everything is "perfect" I start tapering, first to every other night and hold that again for at least a week or ten days....then on one night, off two..... A slow taper. And, as with oral steroids, sometimes if symptoms recur I have to go back to every night for a while.

I imagine there are not really any statistics about how much steroid gets into the system with the steroid enemas.... for one thing, I know that when my system is flaring badly and really ulcerated, more of the steroid gets into my system - I can feel it (weight gain, facial flushing...)
But for the past 20 years I have used them, oh, probably 3 months of any given year.

I am now a convert to the mesalamine enemas for maintenance; I'd always experienced some gas when starting them and had assumed the disagreed with me - but I've discovered that after a week or so that gas went away and they're helping a lot.

But, when things get bad - the enemas are my steroid of choice!

I'm glad things are going well for you!

If you find relief in things other than Imuran I would go for it, obviously.

I've been taking Imuran (azathioprine) for nearly a year now and it's been my absolute life saver. I feel 'normal' again and I can actually be a functioning part of life.

I waited about a month for it to kick in. I got lucky though..

I have mixed feelings for the reasoning behind how its prescribed. I was given Imuran few years ago. It never did anything, BUT the doc was insistent that I stayed on it. I kept getting excuses on why it was better to be on it than not.... blah blah blah. This is bad management of patients. If it doesn't work move on to something else.