Azathioprine and mesalazine-induced effects on the mucosal flora in patients with IBD colitis.

Thank you CM. Very interesting. I work with someone who has done really well on the Aza/5-asa combination for a number of years.

I have been considering aza myself as I have had a difficult couple of years although I am wondering now whether to hold off given that I have discovered that I have been poisoning myself with excess folate through supplementing so much while having a MTHFR c677t mutation.

Got to see I suppose if flare returns after this Pred taper

@ Andrina - That's hard to answer and perhaps depends on your beliefs about the disease. I asked my GI about the combo this morning between the two as I had an appointment with him - he said for UC they tend to see success with the combo, but he has not tried it for Crohn's. So I found his answer intriguing.

Basically if one believes there is a bacterial issue in which the author of this and many other papers believes - so an excess amount of bacteria either adhered to the mucus or epithelial cells is either a cause or major symptom/consequence of the disease, then Imuran (azathioprine) would be a good approach to deal with the excessive leukocite's found in UC folks. But the effect of taking Imuran (according to this paper) causes as much as a 1,000 fold increase in the amount of adhesive bacteria found on the mucus compared to the control group (normal, healthy people), whereas 5-asa had no effect on the leukocytes, but ummm did not promote bacterial adherence.

So the authors thinking is that the combo of the two would be a good option - Imuran to stop/calm the inflammatory side of things (the leukocytes) and 5-asa to minimize or prevent bacterial adherence to the mucus barrier.

So bottom line is the suggestion of taking both for best results.

Does that help or make sense to you?

Thanks Andrina for asking the question and Mark for answering. Yes, interesting now that Mark has explained.

My use (a year or so) of 6mp was a failure and I took mesalamine with it too. I think 6mp caused me to have skin cancer (3 so far and one was pretty bad with higher level of surgery). I also had other bad side-effects from 6mp, (extreme fatigue, dizziness).
Glad this Rx works for some but for me it was bad news.