Hi Norky90.
Azathioprine is an immunomodulator which can help reduce inflammation and increases your chances of staying in remission. You can read more about it
here and you'll find people sharing their experiences with it in the Imuran/Azathioprine/6mp forum
here.
While steroids work fast to reduce inflammation you can't be on them long term and though the steroids may get you into remission a lot of people with Crohn's need a medication to stop them from relapsing. Some even need a medication to start working before they stop steroids so that they can do that without flaring. Mesalazine is a maintenance med for Crohn's but it is considered to be for mild disease.
Newer thinking on the best way to treat Crohn's is to use more aggressive medications sooner to prevent the disease from getting worse and complications developing.
Because doctors don't have a sure way of predicting which patients will develop more severe disease if treated only with the less aggressive medication, it's really difficult for anyone to say for certain the absolute best course for you. Similarly although there are risks and potential side effects from the medication, you may have no problems at all. It's a question of balancing the risks from the disease and the risks from the medication.
Your doctor will monitor you closely by doing frequent blood tests early on when you start azathioprine and then routinely every two months or so if you are stable on it. The blood tests that the doctors do mean that most of the side effects can be avoided because if the medication starts to cause problems you can stop. If you have side effects like fever, aches or nausea when you start you should let your doctor know.
There is believed to be an increased risk of some cancers but this is still a very small risk and thought to be far outweighed by the benefit in terms of reduced need for steroids and surgery.
It doesn't suit everyone but for those who can tolerate the medication the research says it helps people have longer periods of remission.
Hope this helps! It's never easy making a decision about a medication but it's important to give it some thought and unfortunately not taking medications can bring its own risk with Crohn's. Hope you find a treatment that works for you and have a long remission!
