Posted 9/18/2018 6:44 AM (GMT -6)
Welcome back but sorry to hear you're flaring again. Flares suck.
I understand your intent of starting azathioprine, but it's more than a bit dangerous to start taking it on your own, without the required blood monitoring. Azathioprine will take a minimum of 3 months to work, so unfortunately, it is not going to give you quick relief from a flareup. I'd contact your doctor and ask for reintroduction of a blood monitoring (Comprehensive Metabolic Panel/Complete Bloodcell Count and a Hepatic Function Panel).
1.) For quick relief there is steroids (a week or two or less for relief). That's budesonide/uceris/clipper/prednisone or rectal foams, enemas or suppositories.
2.) Increasing your oral Asacol dosage from a maintenance dosage (2,400mgs a day) to a flare dosage (4,800 mgs a day) can take 3-4 weeks for relief.
3.) Reintroducing/Increasing your Pentasa enemas to nightly can take 3-4 weeks for relief.
Depending on how bad the flare is, #2 and #3 might be appropriate, and you might need #1 in there as well.
Most certainly, get a stool test for possible infectious causes to your worsened symptoms. As nasty bugs like c diff mirror UC flare symptoms, we're more prone to c diff, and c diff only responds to antibiotics (steroids make c diff worse).