Joan wrote:I found her to be much less open to PP info than she previously was.

Maybe she checked out the site and discovered that we don't pat many GI docs on the back around here (or to phrase it more succinctly, we don't kiss many GI docs' butts on this board.

).
IMO, skipping budesonide to go straight to Imuran or 6MP is sort of like jumping from the frying pan into the fire. Yes, after about 6 months to a year, budesonide will have limited systemic effects. By contrast, Imuran and 6MP will begin to have major systemic effects much sooner than that. Mercaptopurine (6MP) is a chemotherapy drug used to treat some types of cancer. It fights cancer by preventing cells from making and repairing DNA. Like Imuran, it will lower your white cell count, so your white cell count will have to be monitored while you are taking it. If budesonide is so "dangerous" by comparison, why isn't it necessary to monitor a patient's white cell count when budesonide is used? Because budesonide is not nearly as dangerous to use, that's why.
The problem with drugs that work well for UC is that they target the wrong area for MC. UC always starts at the distal end of the colon (IOW proximal to the rectum), and if it spreads, it propagates backwards from there (back into the sigmoid colon). MC, by contrast, is most active in the terminal ileum (contrary to the training that most GI docs receive), and the ascending (right side) colon. IOW MC is mostly found at the opposite end of the colon, compared with UC.
Maybe the Welchol will provide relief, and you won't have to pick another treatment.
Tex