instruction: hi doctor I am a 27 year old male for the past five years I have ulcerative colitis my main problem is bleeding form rectum when I take prednisolone I am fine for maximum of three months and after that again it starts bleeding and also continues with mesacol I also took azathioprine azoran but those medicines cannot stop bleeding only prednisolone is a solution for me what can I do and if I start taking prednisolone again is that any problem how many times in a year can I take prednisolone in five years I took prednisolone for 10 times please suggest solution
output: hello your history suggests that you have steroid dependent ulcerative colitis so you rightly started azathioprine and I think it should work if you are taking a proper dose you have not shared dose of azoran and your body weight you can take azoran as 5 5 my per keg body weight plus the dose of mesacol is also low increase the dose to at least 4 go day and you can go up to 8 go day maximum regarding frequency of steroid dosing you can take it up to twice per year in case of flare of your disease but it will be better to avoid it if you have a better option azoran because steroid has many long term adverse effects metabolite level of azathioprine complete blood count ear erythrocyte sedimentation rate steroid dependant ulcerative colitis tablet mesacol mesalazine 800 my thrice a day adjust dose of azoran according to metabolite levels avoid nsaids non asteroidal anti inflammatory drugs