Hi...condolences on your miscarriage. I truly believe hormonal extremes as in being pregnant, miscarriages and even periods will cause a flare. I would also imagine the stress on the body during those hormonal peaks as well as the possible distress of one's emotional state could exacerbate symptoms.
Personally, regarding the preg....you're not being pig-headed in any way. I wouldn't go on it until the 5ASA meds weren't working...and it seems for you that if you were to use the Rowasa nightly, you would see even more improvement (since you have already). I was once on Salofalk retention enemas (sam eas Rowasa) for 4 months nightly before I was able to taper to every second night..etc.
Are you still on Imuran and Asacol? How many Asacol?
Your symptoms seem a mild flare probably limited to the rectum...and you starting on Rowasa is awesome . Do do them nightly until you have normal bms..etc...then go another week until you taper to every second night.
You don't have to go on pred, and considering the hormonal swings from the miscarriage, I'd actually suggest you avoid it until things level out...then make the decision if you haven't any improvement.
My take on it.
Hope you feel better soon,
*Heather* Status..Asacol 6 (3 twice daily); enemas every 5th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~Probiotics....(Natural Factors Protec, Primadophilus Reuteri Pearls, Natural Factors Ultimate)....1 each @ bedtime
~various digestive enzymes as needed
~Ranitidine (reflux); Effexor XR 75mg(depression); Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS" worth it !!!