Imuran or Meslamine?

I’d like to ask those of you out there who’ve had an experience with Imuran /Mercaptopurine how it went. I'm familiar with what various online resources say about Imuran but I am interested in your impressions vs those of dry medical text. Are the side effects of Imuran bad, does it make you more prone to getting sick, and is it worth the switch from the presumably safer anti-inflammatory ASA-5 drugs?

My GI has given me the choice of switching from anti-inflammatory based drugs (Asacol/Lialda/Meslamine) to an Immunosuppressant (Imuran /Mercaptopurine) and I’m a little nervous about the prospect of an immunosuppressant. I currently take 4 pills (about 5 grams) of ASA-5 in the mornings and I take 2-3 Meslamine enemas a week for mild/moderate ulcerative proctosigmoiditis (diagnosed early this year). My last endoscopy (several months ago) found me in partial-remission and my attempts since to taper off the enemas have been unsuccessful. My GI recommends the Imuran to 1.) try and get me into full-remission (as I'm likely still in partial-remission) and 2.) to get rid of the enemas (which are a pain in the butt quite literally).

My quality of life on the ASA-5’s isn’t terrible. I have to take an urgent poop after waking up and then a second poop about 10 minutes later. By urgent I mean sometimes I have a few minutes of warning and other times I have just enough time for a mad dash to the bathroom (it varies). My stool varies from well formed to runny (sometimes even within in the same bathroom visit). On a good day I am then done after 2 poops. On a bad day I have a 3rd poop in the mid morning.

My GI says the Imuran would likely be a 1 pill a day thing so the prospect of less pills on a daily basis (1 pill instead of 4) is certainly appealing. My GI says I’ll have to do 1st weekly, then monthly, and finally tri-monthly blood tests to make sure I’m doing okay on Imuran. I guess they check red blood cell counts and other things of that nature. The blood tests every 3 months forever sounds a bit annoying but I guess necessary.

The ASA's are fairly safe. Immuran can have some nasty side effects which aren't good at all. I feel like I am kind of where you are symptom wise. Personally I refuse to take prednisone or any immunosuppressants. I feel good enough about my condition that it is not worth the health risk. I would rather live with life as I have it then take the risk of something that is much worse. It's a crap shoot. You will probably never attain true remission with what you are doing now. I estimate your chances of remission with Immuran at about 25% with a 25% chance that something bad could happen to you due to drug side effects. You have to weigh all that and that's not easy.

Jimbo NZ and Probiotic: I thought my GI said I'd do away with the ASA5 pills entirely and instead use Imuran /Mercaptopurine but that is based on a quick 15 minute whirlwind consultation with the GI so I could've been mistaken. I will call and clarify on that point when I next call my GI. And thanks for the suggestion on the prometheus enzyme test, I will inquire about that.

Garylouisville: I am on the fence on this but I do have a month to think this over before I next see my GI for another endoscopy and a decision on whether to change drugs. I am fairly happy quality of life wise where I am at. However, like all of you in the early stages of this whole uc thing (I am sure) I hope there is a way to make the whole situation less of an inconvenience and a little more predictable (might be a pipedream but I am still somewhat of an optimist). I know the side effects list for the immunosuppressants is much more intimidating (obviously a higher class of drug) and I am sure at least some of them occur with each person (although which side effects are likely different with each person). I do have some very mild side-effects with the ASA5's but nothing all that troubling really: random acne popping up sometimes, sometimes gas, and an increased chance of sunburning. Who knows what I'll get with the immunosuppressants. And certainly on the immunos I'm putting my life more in my GI's hands as he's got to keep a close eye on my red blood cell counts and make sure I don't go anemic or something, which is a risk.

Is complete-remission a myth or are some of you in it?