Prednisone Burst?

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 599
   Posted 6/10/2008 9:44 AM (GMT -6)   
I've been in a flare for over a year and my doctor is a touch unhappy that I won't take steroids.  He thinks getting the colonic inflammation under control will help allevaite the extra-intestinal problems I have, such as joint pain. 
 
He pushed a longer course of steroids but I refused and, after a bit of back and forth, he suggested a five-day course or prednisone.  I told him I'd think about it.
 
It seems like a steroid burst is more appropriate for asthma or some types arthritis.  I can't find any info. regarding this treatment and ulcerative colitis.  Has anyone done this?  Am I setting myself up -- or, being set up -- for a longer course of steroids?  Any suggestions?

AngelTT
Regular Member


Date Joined Jun 2005
Total Posts : 213
   Posted 6/10/2008 10:38 AM (GMT -6)   
Prednisone is what has worked for me time and time again when I flare even while on Prednisone. It was my life-saver two years ago when nothing would work. You don't have to take them long term. Once it knocks down your inflammation it makes it much easier for the doctor to control your disease. I hate the side effects but I would say it is worth it to get healthy. They tried everything else with me and steroids did the trick. I'm on a three-week dose right now and it has helped.
34 year old female, Diagnosed 5 years ago
Current Meds: Remicade every 6 weeks, Prednisone 20mg, Prevacid, Sustenex, Lialda, Lexapro (anxiety), Synthroid, Iron, vitamin, Fish Oil
Expecting first child 12/08 via gestational surrogate!!!!


Judy2
Forum Moderator


Date Joined Mar 2003
Total Posts : 9338
   Posted 6/10/2008 1:03 PM (GMT -6)   
Long-term steroid use is a nightmare, but short courses (less than two months) can usually be tolerated without major side effects. Yes, you may get some emotional reactions and a round face, but the really serious side effects generallycome with longer term use. And honestly, it seems to be the most effective thing to get a flare under control quickly.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2142
   Posted 6/10/2008 2:03 PM (GMT -6)   
besides hot flashes and crying at the drop of.........well anything. My pred side effects did not really kick in until month 3, I was at 60mg a day for the first month and 60/40 alt days for the second and third month. uuugh!
Beth, 32 ~ small flare - hoping caused by aspirin - hydrocortisone e's
Major Flare Sept/Oct 07
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07 - partial remission since 03/08
Prednisone 5mg 1xday (tapered from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Enalapril 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
 


seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 599
   Posted 6/10/2008 2:07 PM (GMT -6)   
Thanks for the advice. 
 
If for no other reason, I don't want the steroids because I try to stay away from anything that might effect my mood, especially when it comes to depression. 
 
I understand the complaints about prednisone side effects here are from statistically few people, but I know a couple of people in real life who regret ever taking steroids for uc. 
 
I might consider a five-day course, but I can't find anything on its effectiveness in uc, and I suspect it might make the situation worse or open the door to longer-term use.  I was hoping someone might have some experience with such treatment. 

ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 6/10/2008 2:55 PM (GMT -6)   
I don't know, I'd think the people who don't get side effects from pred are probably less than those who do. For short periods of time and smaller doses there really isn't that much effect, but you definitely don't want to be on it long term. Throughout high school I would be on prednisone for one month, two at the most, and then off for one month, and then back on (I was steroid dependant) but I never had side effects and was skinny as a rail with no moonface whatsoever. Then after high school I got stuck on pred for almost 6 months and when I looked back at pictures, I had a face the size of a pumpkin, not to mention all the depression and mood swings. Ever since then, I seem to have side effects no matter how long I'm on it for, so I really try to stay away from it at all costs now.
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


Bigphule
Regular Member


Date Joined Dec 2007
Total Posts : 137
   Posted 6/10/2008 2:56 PM (GMT -6)   
I'm sorry seconder I don't understand your desire to avoid prednisone. I've been on some level of prednisone since december. I've never fully gone into remission. Probably because as soon as I started on that path they put me back on 5ASAs that caused a nasty reaction.

I have had some side effects from the prednisone, I wont lie. I've been easily irritable and had issues falling asleep some nights, I've gained a little weight but nothing horrid only about 5 lbs. Now the calcium absorbtion isn't something that I can physically notice, at least not that I know of, and I'm still able to run and be active. I have energy. A little over a week ago my pred was increased to 40mg. Recently the irritability has pretty much passed and for the past few nights I've fallen asleep just fine.

I am sorry but I just don't understand the concerns.

Would someone be willing to explain their concerns to me please?
Diagnosed UC 12/2007
Updated 6/2/08 
 
Prednisone 40mg x 1/day 
Mercaptopurine 50mg x1/day 


ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 6/10/2008 3:06 PM (GMT -6)   
Bigphule,

Prednisone can have some pretty nasty side effects if taken long term and it definitely should not be used for long term therapy ever. It leaches the calcium from your bones and can cause things like osteoporosis, diabetes, avascular necrosis, cushing's syndrome [to name a few], not to mention the more cosmetic side effects that no one likes. A lot of doctors take it very lightly and make it seem like prednisone is just another useful maintenance med but this should not be the case. After being on and off it for only a few years, I have developed osteopenia (when I was only 19, which is completely not normal), I had severe arthritis pains while I was on it that took forever to get rid of, it wreaked havoc on my potassium levels and I had to take supplements for a few months because it was dangerously low, my once perfect vision is gone and I have to wear glasses and I need a stronger prescription already after only a year. And these are the only things that I'm really aware of at the moment.

It's helpful in some/most people in getting them out of a flare, but I can certainly understand anyone's concern for taking it.
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 6/10/2008 3:13 PM (GMT -6)   
There's also dependency problems... "Adrenal suppression occurs if prednisone is taken for longer than 7 days, a condition wherein the body is unable to synthesize natural corticosteroids and becomes dependent on the prednisone taken by the patient. For this reason, prednisone should not be stopped abruptly if taken for longer than seven days; rather the dosage must be reduced slowly. This reduction may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis, which may be life-threatening. For those on chronic therapy, alternate-day dosing may preserve adrenal function, thereby reducing side-effects"
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


Bigphule
Regular Member


Date Joined Dec 2007
Total Posts : 137
   Posted 6/10/2008 3:14 PM (GMT -6)   
I can understand a lot more now, thank you ediekristen. Are those larger side effects a result of long term use? I am concerned now because of how long I've been using prednisone. Sometimes its been a lower does as low as 15mg and as high as 40mg like I am now. I don't know if that matters but still, it isn't something that any of my GI docs have mentioned.

(Thats the problem with the VA Health System, I don't have a specific Dr. I have who ever is next in line.)
Diagnosed UC 12/2007
Updated 6/2/08 
 
Prednisone 40mg x 1/day 
Mercaptopurine 50mg x1/day 


seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 599
   Posted 6/11/2008 7:12 AM (GMT -6)   
Thanks, ediekristen. 
 
Bigphule, I'm not will to risk the side effects.  My doctor is really pro-meds and tends to discount side effects or propose new meds to counter them.  That's not a path I want to head down.
 
Depression is a concern of mine, and I really do have to avoid anything that might provoke it.
 
No offense intended, but I wouldn't take any medication without knowing something about its side effect profile.

quincy
Elite Member


Date Joined May 2003
Total Posts : 25664
   Posted 6/11/2008 9:43 AM (GMT -6)   
Seconder....what meds are you on at this time...dosage, scheduling, etc?

Would the course of pred be one of a tapered dosage? It could be done over 10 days with relatively low or no side effects.

quincy
*Heather*Status: mini flare Dec 28... tapered to every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol (6 daily) + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 3(Natural Factors Protec) bedtime + 1 (Primadophilus Reuteri) occasionally
~multi-digestive enzymes as needed ....zymactive 3 - 5x daily
~Ranitidine,Pariet (reflux) Effexor XR 75mg;  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!


seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 599
   Posted 6/11/2008 5:30 PM (GMT -6)   
Recently on sulfasalzine 2x500xQID. Besides a multivitamin and some fish pills for my cardiac health, that's it. The sulfasalazine seems to be working much better than the Asacol ever did. I'm optimistic.

The five-day course is a continuous taper but I don't know what good that will do. I suppose a ten-day course would also taper all along, but would it be more effective?

Another thing about the prednsone that I don't like is that I can't stop taking it if it causes any problems.

tums
Regular Member


Date Joined Apr 2008
Total Posts : 128
   Posted 6/12/2008 7:38 AM (GMT -6)   
Last year my GP (family doctor) prescribed a 2 week taper of pred to get a flare under control but towards the end of the second week flared up again he then told me to try it again and the same thing happened. I then went to see my GI doctor who put me on a 8 week taper and said that a 2 week taper is just too quick for UC symptoms. So with the mucking about at the start just meant I was taking those horrible little pills for longer.
32 year old female
UC diagnosed 2001
Asacol 6 per day
Azathioprine 50mg started 4/08
Steroids 40mg per day


seconder
Veteran Member


Date Joined Jun 2008
Total Posts : 599
   Posted 6/12/2008 8:01 AM (GMT -6)   
Thanks tums. Thanks everyone.

After reading what I can find, it seems a short taper is probably too short for uc. I'll continue to resist.
New Topic Post Reply Printable Version
Forum Information
Currently it is Wednesday, August 27, 2014 11:54 AM (GMT -6)
There are a total of 2,202,294 posts in 245,129 threads.
View Active Threads


Who's Online
This forum has 155092 registered members. Please welcome our newest member, Spouse4251.
427 Guest(s), 22 Registered Member(s) are currently online.  Details
garylouisville, not creative, Lymecrazed, dragonmother, ericapeace2000, JNF, SubicSquid, Serenity Now, Trotters, MossPiglet, themiz, cilly, Sherrine, Lynnwood, fightUC, Meganofasheville, EPhantom, Traveler, Melaine, Tall Allen, Louise74, dmlvt


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest  Follow HealingWell.com on YouTube
Advertisement
Advertisement

©1996-2014 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer