When Prednisone doesn't work...

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Brad P
Regular Member


Date Joined Feb 2010
Total Posts : 48
   Posted 2/21/2010 11:16 AM (GMT -7)   
...what are one's options? and Remicade isn't one of them confused

I seem to be having a flareup of Crohn's in the duodenum. I think there is an underlying cause to it such as bacteria or yeast. Prednisone is not getting it under control. I was on a combo of Pred, Cipro and Flagyl late Dec and early Jan and that made a big difference but its all wearing off. I see my GI tomorrow luckily but not sure what she can suggest.
CD since Fall 1987
Small Bowel Cancer - Sept 2008
Surgery to remove tumor - Oct 1st, 2008
Chemo - Dec 2008 to May 2009
Jan 2010 - NED

Post Edited (Brad P) : 2/21/2010 10:58:06 AM (GMT-7)


Brian84
Regular Member


Date Joined Mar 2005
Total Posts : 433
   Posted 2/21/2010 11:39 AM (GMT -7)   
Prednisone wasn't working for me so I am now on 60mg of prednisone and Methotrexate injections.

medchrt1
Veteran Member


Date Joined Sep 2005
Total Posts : 517
   Posted 2/21/2010 11:58 AM (GMT -7)   
prednisone acts on the immune system and prostaglandins. Its anti-inflammatory properties when weighed against its insulin suppressancy is questionable. The option is a COX2 inhibitor, and infact there is some benefit to having not suppressed all the prostagladins which prednisone does, (especially cyclopentenone prostaglandin which is know to actually be a anti-inflammatory prostagladin...so theres always another way to look at things). There are books out on coping with prednisone.
I have read that cinnamon is a way to get some benefit naturally, but it seems geared towards anti-fungal results, so I have addressed your bacteria issue. Of course there are a million other anti-inflammatory meds or chemicals out there. thats to replace the anti-infalmmatory properties of prednisone...as far as the immune affects of prednisone that a bit over my head.

Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 2/21/2010 1:22 PM (GMT -7)   
Brad,
 
That's a tough situation. In particular, with a cancer history, a lot of the typical Crohn's medications are a much riskier deal for you. I would suggest asking your doctor about the possibility of doing a course of enteral nutrition (special liquid-formula diet) to induce remission, and then using it as a supplement to help maintain remission. This is a dietary treatment that has been around for 40 years and has been tested in randomized, published, clinical studies in patients with Crohn's disease. It remains a standard treatment for Crohn's in Europe, Canada, and the Far East, but is rarely mentioned as a treatment possibility to patients in the US. The remission rates are very good, but doctors in the US tend to think it's too difficult to ask patients to stick with a liquid diet for several weeks. It might be something to discuss with your GI.

Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 2/21/2010 1:24 PM (GMT -7)   
PS, I should've said, duodenal Crohn's tends to respond quickly to enteral nutrition. You might find that a course of about three weeks of the liquid diet would be enough to clear up the flare.

Brad P
Regular Member


Date Joined Feb 2010
Total Posts : 48
   Posted 2/21/2010 3:26 PM (GMT -7)   
Thanks for the replies. I actually did something similar back in the late 80's and early 90's. I did the tube feeding through the nose. 2L of liquids a day in the evening and night. It replaced half of my meals. It not only induced remission but I gained a ton of weight and grew like a weed. When I was 12-13 and just diagnosed, doctors didn't think I would grow. Now after tube feeding, I am 6ft lol

I would probably ask for the tube via the intestine. I don't really fancy putting a tube up my nose into my stomach again. That was just a nuisance. Getting tangled up in that in your sleep isn't fun lol
CD since Fall 1987
Small Bowel Cancer - Sept 2008
Surgery to remove tumor - Oct 1st, 2008
Chemo - Dec 2008 to May 2009
Jan 2010 - NED


Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 2/21/2010 8:55 PM (GMT -7)   
That's exactly the liquid diet I was talking about. But if you prefer, you can drink it rather than using a tube; it's the same stuff, just with some flavoring added. The taste isn't really exciting, but most people find at least one formula they can tolerate.
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