still get check for blood-loss anemia
the question of prednisone is tricky, and research is not clear of best way to go. Doctor opinions vary. See the excerp about
a study of c-diff infection (CD) among IBD patients.
There is no consensus on whether IBD-related medications, particularly immunomodulators and corticosteroids should be discontinued during the anti-CDI therapy. In a retrospective study of 155 patients from Europe with CDI complicating IBD, 104 (67%) were cotreated with antibiotics and immunomodulators (defined as the use of prednisone, azathioprine/6-mercaptopurine, methotrexate, biologics, cyclosporine, tacrolimus) for their C. difficile-associated IBD exacerbation, while the remaining 51 (33%) were treated with antibiotics alone. The primary outcome of the study was colon perforation or toxic megacolon, shock, colectomy, and mortality. Patients treated by combination therapy had a trend towards a worse outcome when compared to those treated by antibiotics alone (likelihood ratio = 11.9; 95% CI: 0.9-157). Thus in most patients with CDI, it may be inappropriate to escalate immunosuppressive therapy during the acute CDI episode. However, the question of whether to add immunomodulator therapy in patients who are not on it before the CDI episode remains unanswered. In a recent survey of 169 North American gastroenterologists, there was significant disagreement on whether combination antibiotics and immunomodulators or antibiotics alone should be given to flaring IBD patients with CDI. Overall, 77/169 (46%) of the respondents elected to add on corticosteroids as a combined treatment with antibiotics, whereas 82/169 (54%) treated the flare with antibiotics alone. When maintenance azathioprine was regularly taken, only 11% of respondents withdrew it upon the diagnosis of CDI.
if it is not c-diff, a pred taper may help a lot if you tolorate pred fairly well. if IS c-diff and antibiotics does not help, or it reoccurs, read up on FT for c-diff. Expensive and hard to find, but effective.
Post Edited (DBwithUC) : 1/17/2014 7:03:18 PM (GMT-7)