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Azathioprine and flaring??? Advise

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Ulcerative Colitis
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Posted 1/4/2016 3:02 PM (GMT 0)
Hi Gang

I havent been on here for a very long time as have been doing really well on Aza medication, where i sustained normality for about 4-5 months.

Then Christmas came.....

....i thought as all was going so well that i'd have a "good" christmas and probably over did it when the rich foods and alcohol on christmas day. Boxing day came and i was full of gas, and then over the last week it's progressively got worse. I am now have 4-6 BMs a day, with a heck load of mucus and blood. The gas and pain has gone though.

I am on 2 AZA tabs a day, have upped my balsalazide to 750MG a day and have just started nightly enemas again. Have done this a few days and i'm not seeing any improvements.

Has anyone else ever flared whilst on AZA? My understanding was that this condition was an immune response, if my immune system is suppressed how is that happening?

thanks all
Posted 1/4/2016 3:46 PM (GMT 0)
It is mildly suppressed, but the IBD has overwhelmed it. Many people flare or have disease progression on AZA, or they never would have invented biologics.

from what I read, 750MG is still low for balsalazide. you could try more to help AZA get back in control.

you can have AZA metabolites checked to see if your body is using the drug efficiently. also, a short pred taper may get you back on track.

possibly you can use a low residue elimination diet to manage symptoms until the inflammation is once again managed.

good luck
Posted 1/4/2016 4:32 PM (GMT 0)
Even strong uc medications cannot prevent flares from occurring.

I'd get a stool test to check for pathogenic causes to your flare (cdiff is always possible).

What's your total aza dose? It's weight-based and 150-225mgs a day is a typical dose. A thiopurine metabolites bloodtest will tell you if you're within optimal therapeutic range. Dosage can be increased or decreased based on your test results.

What's your total balsalazide dose?
The usual dose is 2250 mg (three 750 mg capsules).
Posted 1/4/2016 5:03 PM (GMT 0)
Thanks for the replies.

Sorry I'm being a wally. I am taking 3 X 750mg balsalzide daily. Also a salofalk enema each night.

I have called my nurse to see what they want me to do just waiting for response. I think a blood test is in order as this flare feels on or with my first and is starting to hurt a bit when I go to the loo.
Posted 1/4/2016 8:34 PM (GMT 0)
agree with ipoop
its also important to get it under control before it gets bad

ask them to order the stool test as "STAT" so you can get results quickly
Posted 1/4/2016 9:52 PM (GMT 0)
I agree with the others, you should do the stool test, maybe it's something you can treat and you will get back to remission. In my case, I stopped responding to 6mp after a year or two. It was like my UC learned how to progress past whatever i put in its way. Evil illness. Get your levels checked for Aza, if you're low in the therapeutic range, you may be able to increase the dose and see result.
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