Brief Answer: Ask your doctor to consider options given below Detailed Answer: Hello Mr. XXXXXXX Thanks for posting your query on this forum. I can fully understand the agony that you are passing through. Your ulcerative colitis has apparently become steroid-dependent, necessitating introduction of Azoran, apart from continuing Balacol. Efficacy of Azoran can be seen as early as 3–4 weeks but can take up to 4–6 months. You have already been on Azoran for about 4 months. The effect should hopefully come in the next few weeks. Had I been your treating physician- given the relapse of symptoms- I would have re-introduced oral steroids in gradually increasing doses and stabilize on minimum effective dose to suppress the relapsing symptoms. Thereafter, the dose of steroids would have been tapered off VERY GRADUALLY, once the effect of Azoran comes up. Thus, your Gastroenterologist has the following options :- * consider increase in the dose of Azoran * Re-introduce steroids in low doses for a short period, till Azoran's effect is manifest, or * in the event of your condition's failure to respond to Azoran despite an adequate trial, consider anti-TNF therapy, which is quite expensive and also has potentially serious side effects in susceptible people. Consult your Gastroenterologist and apprise him of my opinion. I am certain that he will agree with me and actively consider the options mentioned above. Hope I have addressed your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards, Col (Dr.) Rakesh Karanwal

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