Some people are on the 5ASAs, in oral and rectal combo.
There is a LOT of research that shows that patients who use both reach remission more quickly and stay in remission longer (w/ a maintenance dose of twice weekly) than those who only use oral meds. It makes sense, as the oral 5ASAs don't do a great job at treating the distal colon, and the enemas do a wonderful job at that.
Some people are in the 6MP with oral and rectal combo AND Prednisone
Well, there is no rectal 6MP. Just rectal mesalamine and steroids. And since it takes 6MP a while to work, many people are also on pred when they start it.
Some people on on Remicide or other biologics with all kind of combo types.
Yup. There's really no downside to staying on mesalamine with any of the other drugs, assuming you're not intolerant to it. There is some evidence that being on 6MP or Imuran along with a biologic can increase your cancer risk, but I'm not sure how strong/good that evidence is.
Is there never just one solution? If you are on 6mp, why then do you need pred?
You mean can a person stay in remission on just one drug? Sure. I could *probably* stay in remission on just Apriso, since I'm doing so well, but I'm not going to risk it.
Are any of the darn drugs working? Are the med side effects worse then the blood and mucous and cramps and D?
Yes, my drugs are working quite, quite, well, as I've been in remission almost 4.5 years. Or maybe my UC is just in remission all by itself. But who really knows. And I have no side effects, so using the meds is much, much better than having symptoms. Also remember that you're more likely to develop really bad stuff like toxic megacolon, colon perforations if your UC is left untreated.
Do each of us start with 5ASAs then move to the next and then the next and then the next for.ev.er?
Pretty much everyone starts with the 5ASAs, although for very severe cases, some docs use the "top down" approach, where they start with a biologic, get the UC into a solid remission, then switch to a 5ASA drug. It can work very well.
Can anyone say that they have stuck with a plan and it worked for them for.ev.er? So far that is.
Quincy has had UC for 20-ish years and has only ever used oral and rectal 5ASAs. I had to use pred to get into remission, but I'm doing really well and my GI says he suspects I will continue to do well.
I just feel like we each are chasing our tails (butts) all over the pharmacutical map.
For some people, yes, it can take a while to find meds that work. For some, meds never work. The important thing is to BE PATIENT and give things time to work and not jump from treatment to treatment. I sort of get the sense you're not being too patient.
I have no problems with the drugs if they work, but do they? Are they?
Yes, for some, but not for all. I mean, I see a lot of ocmments about UC being so tough to manage, complaints that there's not one drug that works for everyone, but to be honest, I can't think of one chronic disease that IS easy to manage, and that has one drug that works for everyone who has it.