What would you do?

Been flaring for 14 months, with multiple loose stools or diarreah most days, regular bleeding, urgency etc. Failed Remicade. Inflammation is moderate as of a few weeks ago (which seemingly hasn't got better or worse since October). I believe from the past it is more on the moderate to severe side.

I have been on pred rectal foam and mesalazine liquid enemas for months. I started sulfasalazine oral 2g a day nearly two weeks ago. Not sure if I've noticed any improvements yet - how long does this drug take to work? Should I try upping the dose?

Would you recommend I try Entyvio now or see if I can get it under control with something else first? Other stuff floating around as possibilities at this point include azathioprine and cyclosporine.

I'm also contemplating adding in a low dose of CBD oil but not sure if it'd help as much as it might just end up interfering with the stuff I'm already on.

What do you think?

Azathioprine is a lot cheaper than Entyvio if you haven't tried it yet. Else I'd give Entyvio a shot. Both need some time to work.

I'd throw an immunomodulator and entyvio at it. The combined effect might be enough to win against your UC flare.

Cyclosporine is a quick, emergency rescue medication much like pred. Azathioprine takes 3 months to reach ideal therapeutic (healing) range.

Entyvio is also slow working up to 3 months for a response.

Sure, I'd try upping the dose. As typical flare dose of sulfasalazine is 3 to 4 grams a day. A typical maintenance dose of sulfasalazine is 2 grams a day.

Essentially, you've been on a maintenance dose of sulfasalazine thus far. Just watch out for side effects as a precaution as you increase your dosage. Some never get them, some do. Higher incidense with sulfasalazine than with the mesalamine-based meds.