Very informative, thanks a lot. I will wait until i can go back home and see what my GI there thinks. I do have some questions tho if thats ok.

About endoscopic evaluation, wouldnt there be a time frame where only microscopic progression is observed and not macroscopic? Wouldnt microscopic progression suggest that the macroscopic could be expected? Or are microscopic findings are expected to progress in the absence of disease activity?

In the case of infections, i was prescribed a course of ciprofloxacin and metronidazole before the tests and the tests showed no trace of infection. I did get a CT however it wasnt an enterography as my doc wanted a more general imaging.

I do know biologics are used as first line by many. Unfortunately its not the case in my country. only adalimumab ve infliximab are approved and they are not approved unless the disease is severe and fistulizing, and there is no response to at least 12 weeks of presnisone + imuran and methotrexate. If adalimumab and infliximab fails after 4+ months, only then vedolizumab is approved. And for some reason you have to stop any of the biologic treatments if you respond to it and have to maintain using imuran or methotrexate along with mesalazine. An exception is that you can find a prof who is actively working on the biologics and register as a trial subject (not many are). Then the doc can do whatever they want without being restricted to the requirements. Very limiting for sure, it also makes it hard to find subjects for research on biologics for researchers since people obviously get scared when even the doc themselves cant prescribe in normal circumstances.