It's possible you could be experiencing IBS symptoms at this point. It's also possible you still have lingering uc inflammation. When was the last time you've had a flexible-sigmoidoscopy or colonoscopy with biopsies? A lot has improved but you're still experiencing some plausible uc symptoms that warrant further clinical investigation. It would be good to know how far and how severe the actual remaining inflammation is, and really any changes to your treatment or medication should be based entirely on that assessment and it's results. At minimum a fecal calprotein or crp blood test should be done to assess how much inflammation remains, but a scope is always much better and more accurate.
Rowasa is always a good start, but you do have pancolitis and if you have higher up inflammation then it won't all be treated by it. Scope should say.
If your scope results are bad, then starting azathioprine is less optional and more essential. Everyone is a little nervous before starting immunomodulators, I know I was. There most certainly are some scary side effects listed. For me, it helped to weigh the risks versus the benefits. about
70 percent of patients have an improvement in their uc symptoms on aza. Side effects are statically small (less than one percent experience the worst of them). A good read on risks versus benefits is this from the Crohn's and Colitis Foundation of America, which describes the side effects and the actual odds of getting them:
Moderator Ulcerative Colitis
John, 37, UC in histological remission
Rx: Remicade @5mgs/kg/8wksWords containing "UC" both literally and figuratively: sUCk, ouch, deuce, mucus, f-ed, lucifer, and luck.
Post Edited (iPoop) : 3/30/2016 1:55:21 PM (GMT-6)