Hmm, usually a GI will try Imuran or 6MP and then Remicade before thinking about
surgery--or at least that's what my GI did. He didn't even bring up talking to a surgeon until my last appointment (even though I had brought it up in previous appts and he just dismissed it) when I said Remi wasn't helping much. However, if you listen to the webcast leemega posted, the doctor says to begin talking to a surgeon as a precaution when the first-line meds (I'm assuming 5-ASAs) fail.
I can't comment on how much Imuran will help b/c it only took two days of 6MP (which is similar to Imuran) for me to get side effects and have me hospitalized. I've had two Remi infusions so far--there have been a couple good days but the rest have been normal flare days. My GI says that if Remi doesn't work in a week or so (4 weeks since I started), surgery is going to become a definite option. My GI isn't willing to have me try Humira if Remi doesn't work since they're both very similar--so whether that's an option for you will depend on your GI.
I personally think your GI is jumping the gun, but it still wouldn't hurt to talk to a surgeon even if you decide on meds like Imuran and Remicade.
Female, Age 19, Dx w/ UC August 2007
9 Asacol, Rowasa, 1000 mg Canasa, Proctofoam, Rifaximin 2/day
Digestive Advantage (Crohn's & Colitis), 1 Florastor, 50 mg 6MP,1 Primadophilus reuteri, 1 DanActive, Remicade (2nd infusion 06/26/08), 2.4 g Lialda