Wow, butterfat, thanks for posting this topic. It's pretty similar to what I'm going through. My GI is a very visual person, apparantly, and since he sees active disease when I have a scope, he thinks I need stronger drugs. But I feel good and I don't want to mess with drugs if I don't have to. I understand the concept that the disease can be doing damage, even if I don't have symptoms, but it's still a hard pill to swallow (haha!). I think what it comes down to for me is kind of a case of denial. I don't deny that I have the disease and that without treatment it will come back but... I just want to live my life and not have to worry about
it for awhile, and being pretty symptom-free allows me to do that.
Fortunately for stubborn ol' me, my GI usually goes along with what I want to do, and so I'm just on Pentasa for maintenance, although he keeps pushing Humira on me and I keep saying "not now". You asked about
monitoring for disease via blood tests- Currently I get my ESR/sed rate done every two months or so, and for me that's always been a pretty reliable indicator of general disease activity.
Honestly, in my situation, there is no way I would take prednisone right now. The side effects are just too much and would mess up my life at the moment. Your GI probably wants to start pred as a quick way to reduce the disease activity, but if you feel ok and don't want to go through with that evil stuff, don't do it. Like others have mentioned, I'd go for 6MP or Imuran if I were you. They are stronger drugs, but they have fewer acute side effects than pred. Or maybe even ask about
Remicade or Humira, because many doctors are starting to think that it's better to use the "big guns" first, and the side effects of those can be minimal as well. According to my GI, those drugs are safer than the 6MP variety for pregnancy, but I know other people have had healthy pregnancies on immunosupressants, so it can depend.
Whatever you decide, good luck, and I hope you continue feeling well!