Stay on Rowasa when starting Prednisone?

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MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 6/29/2008 10:08 PM (GMT -6)   
Hi everybody, thanks for all your advice so far.  For any of you who were taking mesalamine enemas (Rowasa) before starting Prednisone, did you stay on them after you started the Pred? I'm was taking 2 enemas a day for the past 4 days to try to get over the flare but it didn't work. Wondering if I should keep taking 2 enemas a day now that I started the Pred, or if I should go down to just one enema at night? I'm hesitant to stop them all together since I usually need at least 1 every other night to maintain remission lately. 
 
Thanks!
Nikki

quincy
Elite Member


Date Joined May 2003
Total Posts : 30681
   Posted 6/30/2008 2:55 AM (GMT -6)   
It can take weeks to get over a flare by taking the enemas....4 days with no matter how much 5ASA meds, won't get you over a flare.

Why did you feel you needed to start the pred?

Are you also taking an oral 5ASA such as Asacol or Colazal..etc?

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 !!!


MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 6/30/2008 6:20 AM (GMT -6)   
Yes, I take Colazal, 3 pills 3 times a day and have for years and years.  I started the pred because just about everybody else on here told me to start it. I'm going on vacation in 2 days and waiting 4 weeks to get over a flare wasn't really too appealing to me.  Also, for me, usually the enemas (twice a day) start working in a few days.  I haven't been able to eat hardly anything for the past week and have had horrible abdominal cramps - something I don't usually get with a flare that the enemas clear up.  I also was having a heck of a time keeping the enemas in, so I doubt they have been doing the job they are supposed to.  I'm glad I started taking the pred, I am pretty sure if I waited a few more weeks without eating I'd be in pretty sad shape by that time.  I've had the illness for about 14 years now and this seems to be quite a bad flare.

quincy
Elite Member


Date Joined May 2003
Total Posts : 30681
   Posted 6/30/2008 11:16 AM (GMT -6)   
I can understand you wanting to feel better soon since you're going on vacation.....it could be just what you need since so many report feeling pretty darned good while on holidays...hope that holds true for you.

Were you tapered to a maintenanced dosage of the enemas or had you stopped them completely before having more severe symptoms?

I wouldn't stop the enemas, just use one nightly....even a half as some have done if they can't hold them in (use the other half the next night)...or use Canasa supps until you've improved a bit till you can hold them in.

One thing that you could try is start squeezing a bit as you just insert the nozzle to get the med at the start of the rectum, push it in while squeezing the med and withdraw a bit to just inside the anus...it'll concentrate the med better in that area.

How long will you be on the pred...what dosage? will you be tapering it?
I don't have experience with it since the 5ASA asacol and Salofalk enemas tapered and increased have been working well.

Hope you feel better soon.
q
*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 !!!


MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 6/30/2008 12:08 PM (GMT -6)   
I've actually been taking the enemas nightly for many, many months now. Maybe 6 months?  I had tried a few times to take them every other night but usually started to get flare symptoms. So for the past 4-6 months I"ve been taking them every night.  Had just went up to 2 enemas a day a few days ago because of the flare I have now.
 
Just started the Prednisone yesterday. I'm on 40mg for a week, then 30, then 20, then 15, 10, 5 - 6 week course.  I'm going back to the doc today, they wanted to see me to run some tests (xray or CT scan or something) since I was still having issues with abdominal pain all weekend and can't really eat.
 
My inflamation is up the left side of my colon, so the supp's won't work for me anymore (they used to 14 years ago when it was only inflamed at the very bottom - proctitis at that point only).  I went many, many years (10??) with just asacol - then Colazal - keeping me in remission.  It seems though that the past few years this isn't enough anymore.  My disease seems to be changing a bit the longer I have it.
I've only had to take Pred once before, about 13 years ago. It knocked out my flare and put me into about a 5-7 year remission.  I'm just hoping this time it clears up my symptoms and allows me to eat again! :)
 
I'll keep taking the enemas nightly as I normally would for maintenance.  I didn't take it this morning as I woke up with horrible stomach cramps and had to run to the bathroom - I had at least kept most of the enema from last night in for around 7 hours at that point.  I just think if I can get the stomach spasms to calm down things might get a little better.
 
Does anybody know of anything you can take to help those pains? The doc never gives any suggestions.  I have Levsin but it does nothing when the pains are this bad.
 
Thanks,
Nikki

quincy
Elite Member


Date Joined May 2003
Total Posts : 30681
   Posted 7/1/2008 12:39 AM (GMT -6)   
Hi...maybe something else is going on? Considering you're flaring with taking the oral and rectal 5ASA, you should have your doc do a check of your stool samples to rule out any nasties in your colon.

When was your last colonoscopy?

You might want to consider to start taking probiotics and possibly a fibre supplement to help bulk up the stool a bit and help with the diarrhea.

I sure hope your doctor will help get it sorted out and not only assume it's your UC.

In case I haven't done so.....welcome to the forum!
quincy

Keep us posted...
*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 !!!


MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 7/1/2008 6:20 AM (GMT -6)   

I gave a few stool samples last week, but the results haven't come in yet. I'm due for my next colonoscopy sometime in Jan-March next year.  I actually already take a probiotic acidopholus and have been for years. But I'm going to go out tonight and find a new one and see if that helps at all.

Still having abdominal cramps but didn't wake up at all last night having to go to the bathroom.  Didn't have quite as many cramps yesterday and didn't use the bathroom as much (even when I ate in the evening).  Hopefully things are getting a little better.  Pretty sure now though its my UC as I had pain in my left side last night and my muscles are aching a bit - both signs of a flare for me usually.  Not sure if the Pred can cause muscle aches or not though.  I was having some joint pain as well last night.

Thanks again for all the advice? 

Nikki


MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 7/1/2008 9:59 AM (GMT -6)   
Update: well stool samples came back normal, I just got a call this morning.  Blood tests were normal too.  Looks like its the UC flaring as suspected.  I'm going to go get some heavy duty probiotics tonight (better than what I have now) and see if that helps the tummy a bit. Dr also prescribed some Bentyl, I'll see if that does anything for the cramping.  So far today, not doing too bad. Maybe the Pred is actually working. :) Something is making me awful gassy and a little bloated though, but that's something I am used to and better than massive cramping, that's for sure. Just hand me the Gas-X I guess :)
 
 

quincy
Elite Member


Date Joined May 2003
Total Posts : 30681
   Posted 7/1/2008 10:52 AM (GMT -6)   
Great news....well, you know what I mean!

The Bentyl is awesome for me (in Canada it's called Bentylol)...what dosage are you on?

Apparently, the pred can cause muscle cramping...as can UC flares. Double whammy.

q
*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 !!!


MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 7/1/2008 11:06 AM (GMT -6)   
I think she prescribed me 1 pill twice a day. The prescription wasn't ready when I went to pick it up yesterday so I'll be getting it after work tonight and trying it out.  Hopefully it works better than the Levsin, which has finally started to help a 'little' bit I've noticed. Hopefully that's a good sign too. So far today (at 11am!) no stomach cramping. Yay!  Pred is making me a little hyper though. :)
 
Nikki
 

thatfield
Veteran Member


Date Joined Jul 2008
Total Posts : 823
   Posted 7/1/2008 12:56 PM (GMT -6)   
Hi Niki - I am new to this forum.  I am going to my doctor this afternoon for the fourth time in the last 10 months and I think he is going to want to start me on an oral steroid this time.  Nothing else is working well.  I am nervous about the side effects...do you have any bad ones with the Pred?
 
 

MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 7/1/2008 1:03 PM (GMT -6)   
Depends on the dose of prednisone you get. So far I've been taking 40mg for 3 days and I've got some joint and muscle pain.  Also a little indigestion. But I haven't been running to the bathroom and stomach cramps aren't as frequent - so it may be working? I am hoping it is.  If you are having quite a bit of trouble and nothing else seems to be working, I'd say try a short course of Prednisone. If you have never taken it before it has a better chance of helping you.  Most side effects are when you taper the dose.

thatfield
Veteran Member


Date Joined Jul 2008
Total Posts : 823
   Posted 7/1/2008 5:53 PM (GMT -6)   
I was given 20MG a day for four weeks then I am suppose to go down to 10MG a day for four weeks then take 10MG every other day for four weeks...  I am really hoping this helps and that it does not cause other side effects!  I have been on everything else since Nov. with not much luck so I have high hopes this will put me in remission.
 

MNBeachgal
Veteran Member


Date Joined Jun 2008
Total Posts : 867
   Posted 7/1/2008 5:59 PM (GMT -6)   
20mg is a pretty low dose. Everybody is different though of course. It all depends on how well your body can deal with drug.  Being on it 4 weeks at 20mg, you will probably notice some side effects. But if they are bothersome you can always ask your doc about it.
I've started to notice more gas and just a sort of 'achy' stomach feeling since I've been taking them.  Also I can really feel that colon 'popping' with that gas in there.  Not sure if that is from the Prednisone or not though?  I think if they help you out, the side effects will likely be worth it to get you out of such a long flare.

thatfield
Veteran Member


Date Joined Jul 2008
Total Posts : 823
   Posted 7/3/2008 11:28 AM (GMT -6)   
Yes, I agree! This has been going on way too long and I have had quite a bit of bleeding associated with it so I am willing to deal with almost anythign to get this stopped. In fact, I seem to already be doing a little better and I have only been on the pred since Tuesday! I hope it is really helping and not just something I am imagining. :)
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