Budesonide

Hi everyone. I have had Coltiis since 2013 and have been on azathioprine for 4 years after failing mesalamine. I took prednisone once for a bad flare and it worked very well. Azathioprine has been very effective and kept me in remission for 4 years until a minor but stubborn flare that started June 2021. I tried entocort enemas for 8 weeks which helped, but every time I tapered them I would have blood again. My GI put me on 9mg cortiment (budesonide) for 8 weeks and it put me in full remission. I just stopped cortiment 2 days ago and saw a small amount of blood streaked stool today. I'm not going to jump to conclusions, but does anyone have suggestions on what could be done if I can't taper off budesonide? I'm not sure if it comes in 6mg or 3mg tablets... does this mean I've failed aza? Any suggestions, tips, words of wisdom, stories of hope would be much appreciated.

Quincy will probably pop in to offer advise re: enemas — she’s the expert and very wise but she might advise you to stay on them longer and then taper to a maintenance schedule of every 3 days.

Regarding budesonide as I recall they say you don’t need to taper it when you stop. I would probably go back on it if it was working for you and then talk to your dr about long term solutions if the enemas don’t work or help.

I went on a biologic because I was steroid refractive — meaning steroids (prednisone) worked great for me and my symptoms but every time I went below 20 MG my symptoms would return.

Thank you all for your suggestions. I did have the aza blood test a few years ago to check the therapeutic range, but not recently so that's a great suggestion. I will also ask my gastro about 3mg tablets of cortiment so I can stay on them a bit longer if I continue to have blood in my stool. I live in Canada (Ontario) so I'm not sure if they are available here. Thank you all for your advice!

I was on mesalamine enemas for maintenance every 2-3 nights from 2013 - 2018. I have ulcerative proctitis so they helped when I had minor flares for a few years. In 2017 I had a bad flare and was put in 4mg oral mesalamine plus the enemas. It wasn't effective and within a week of the oral mesalamine I had a terrible reaction - severe sore throat, fatigue, body aches, constant headache. My gastro told me to stop taking the oral mesalamine and everything went away, so she determined I had an allergy. I was put on cortifoam enemas after that and went into remission pretty quickly.