UC proctitis flare. Doc wants to go to biologics.

I was diagnosed with UC January of last year. I got into remission shortly after with the help of prednisone and mesalamine oral medication and enemas. I’ve recently been dealing with return of symptoms the past three months, but mainly in the form of proctitis. This was confirmed by a flex sig that showed no inflammation higher up in my colon. This matches with my symptoms of bright blood streaked on formed stools. No diarrhea, liquid, mucus, etc. like I had when my whole colon was inflamed. After the flex sig, GI prescribed Canasa 2x a day that helped get rid of most of the symptoms except for the blood. I’m back to one movement a day, formed, blood streaked on the tail end of the stool.

The past couple of visits my GI has mentioned going the biologic route. I asked about doing another round of prednisone but he says that it would just keep coming back. I’m not too sure because I was doing really well with maintenance mesalamine oral and enemas until I started to reduce enemas to every third day. (Stupid, don’t stop taking meds if you are feeling good and have no side effects). So, I’m more open to trying to get back to that. Doc doesn’t like 6mp.

I ordered some extra mesalamine suppositories generics from a Canadian pharmacy hopefully trying to do 2x a day to knock this out. I also might try and get him to prescribe me hydrocortisone enemas. Also, I will ask about medical cannabis, but I’m more focused on traditional medications first.

I’m not opposed to biologics, but want to make sure I don’t jump into them before I need to so I don’t exhaust my options. My doc has always been vigilant about treating symptoms quick and not letting long term damage happen – of which I am appreciative of, but other than the little bit of blood, I’m feeling quite good… even general bloatyness and gas has been less recently.

Any suggestions or experiences would be appreciated. Thanks