azathioprine success stories/when to try aza

So i posted a few weeks ago about symptoms of bleeding starting again, and a noisy rectum.

The rumbling noises have stopped and im able to work and go to meetings without embarrassment.

the blood stopped after 3 weeks, and under doctors orders i tried to taper to enemas every other night.

i began to see slight bright red blood on the tp on the off days.

so i took suppositories in the morning and enema at night and then just a suppository at night and for a few days no blood the next days, including this morning.

however after just going again in the evening i again saw a small amount of bright red blood on the tp, having not used a supp in the morning.

prior to all this, the last time i actually flared was a huge pancolitis flare that took months to die down so im glad its not got to that stage!! it was brought into remission by prednisolone and then maintained with mezavant and salofalk enemas. that was 9 months of remission!

my doctor says i am technically flaring and will need to take pred again.

i haaated pred and got all the side effects possible.

so :

will i definitely need to start as high as 40mg again for this tiny bit of blood?

what is the fastest taper possible seeing as i'm not badly flaring at all?

and now i'm considering azathioprine which my doctor encouraged - so could anyone give me positive success stories from it? did it maintain a remission from both proctitis and higher up inflammation (which i'm controlling well anyway?) will i be able to stop rectal meds somewhat?

id just like to stop tailoring my routine and thoughts to this disease.

but (and i know this sounds silly) id also like to enjoy summer when it comes without being on a cocktail of drugs that will make my skin super sensitive and make me fat!


(currently on mezavant & salofalk rectals as well as turmeric and boswellia)

is it all sun or just summer sun? and how bad is the nausea?

I've been taking azathioprine for about 7 months. I started it when I finally realized I was mesalamine intolerant. I wouldn't say that I'm completely in remission yet, but going from running to the bathroom 20-30 times a day down to 4-5 in the morning is an enormous improvement. Side effects-wise, nausea and fatigue were my chief complaints. The nausea improved after the first three months, and my doctor has given me a prescription for Zofran to manage it in the meantime. The fatigue has gotten worse. I'm constantly weak and exhausted. At least three times a week, I go to bed the minute I get home from work. My doctor prescribed weekly B12 shots to help with the fatigue three months ago, but so far, they don't seem to make a difference.
Regardless, if the choice is fatigue or 20-30 trip to the bathroom per day, I'll take the fatigue.

I was on 6mp (very similar to azathioprine) for about 2.5 years. I never got any side effects from it. Eventually progressed to remicade which put me into remission.

about 20 percent of patients experience nausea when first starting azathioprine. I didn't experience it, myself. The best thing to reduce the odds of nausea is take aza just before bedtime with a snack. Those who experience nausea only do for the first 2-3 weeks and then it's supposed to go away.

While on azathioprine, you will sunburn easier. If you're going to be outside for multiple hours in direct sun, then take precautions. Put on sunscreen, wear a hat that'll shade your face, and find shade whenever you reasonably can. I was pretty forgetful, and sometimes remembered (but honestly not nearly as often as I should've lol), I'm an outdoorsy and active guy and I'm out in the sun a lot. Worst I got was some sunburning and peeling the next day. Azathioprine does very slightly increase your odds of melanoma (skin cancer), so over the long term, you should be more cautious with extended, direct exposure. Self-screening is a good idea for any bizarrely changing spots on your skin. My primary care doctor always screens his patients backs (where it's hard to see yourself) for that sort of thing. So, go out have fun in the sun, use a little caution, and occasional preventative screening is always good!

Thanks for posting. [My next level of medication will be Imuran, too. Certainly concerned after reading up on it.]

I started aza nearly 3 months ago with no side effects so far, not even nausea. I was faced with the choice 2 years ago and now regret it after the worst flare ever which needed hospitalisation. My consultant said I was living with the disease at too high a level so that 5 to 6 BMs a day was considered normal. I am happy to step up if it means better control and avoiding the dreaded steroids, which have wrecked my health and now no longer work. Good luck!

thanks all for your replies!

currently still bleeding - i just need to remember how long it takes to heal with uc

anyone have experience with salofalk suppositories?

as for the azathioprine - i'm almost willing to take it just to stop this constant management of uc hiccups and uncertainty over whether i'll get back to remission with mesalamine, despite my lack of symptoms (for now!)

very hard to think about as a person in their early 20s!