Advice about next medication to switch

Hello lovely people. I've been having mild proctitis for 15 years now, until last year, when after major flare it turned into pancolitis. It is quiescent now, I have inflammation and no symptoms - I suspect it was like that for the last several years. I live in UK, and both private and NHS consultants are of the opinion, that while there are no symptoms I should just stick to Salofalk. I want to seek another opinion but be prepared on my part. Which medicine might be the next step? Thank you all in advance

Post Edited (janeze) : 2/17/2020 9:11:11 AM (GMT-7)

Well, I am using enemas when I have occasional mild symptoms . And during flares of course. I just presumed, considering for how long I have it, that ever-present inflammation should be addressed with some next level drug...

Aaa... Enema as additional daily maintenance tool. I'll try that, thank you. They don't reach the very end though...

My doc had me do six weeks of daily mesalamine enemas (alongside oral Lialda) to see if we could get to endoscopic remission without escalating to biologics. When it failed, I tried six weeks of Uceris. When that failed, then I moved on to Entyvio.

Could you do a calprotectin test instead? I wondered about that, how you were going to know if you have no symptoms. Honestly, if it were me, I wouldn't do a thing.

I seem to be relatively safe on salofalk granules with little to no symptoms. All be it I’m only two years into my UC
I do use salofalk suppositories every other night as well as my granules. They are just part of my routine of maintenance.

If I get an increase of symptoms, i up my granules today full dose, and use a suppository in the morning and at night.

If you feel an increase or upgrade of medication is warranted, then I’m sure you will be listened to.
But personally I’d rather stick with my salofalk for as long as possible if I can, other drugs come with other potential side effects.
But absolutely worth weighing up the benefits, and I understand your worry about the increased cancer risk.

Good luck!