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Ulcerative Colitis
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Posted 10/26/2007 9:30 AM (GMT -8)

Hello!  I am new to this site.  I have question on prednisone tapering and symptoms to expect.

Symptom free UC diagnosed April 2006.  Rowasa enemas for six weeks. 

Hospitalized for 28 days in June 2007 for flare and MRSA infection.  UC broughtunder control with Remicade.  Only had one infusion because I caught MRSA a few days later.  Second infusion was tried 13 weeks later.  Developed rash, low bp, hives.  GI doctor stopped infusion and will not being having another one.

I started with Rowasa enemas nightly and Asacol in March 2007 to hel with flare.  BMs (10-20 times per day), D but no blood.  Prescribed 60mg Prednisone in April.  BMs down to 4-5 per day.  Taper started in early May at 10mg every two weeks.  Down to 40mg prior to hospitalization.

On 40mg pred since leaveing hospital.  BMs (1-2 per day with formed stools).  Started taper at 10mg for two weeks.  No issues.  Down to 25mg, no issues.  down to 20mg and no issues for 10 days.  Then started having loose BMs (still 1-2 per day). Two days ago saw blood in stool and the paper.  Same day blood work looked good.  GI said results indicate inflammation under control.  He also said blood not unusual at this point.  Keeping at 20mg pred until BMs become solid or symptoms get much worse.  Next appointment in 1 month.

Quesion:  have others seen an increase in symptoms during a pred taper?  Should a bump of the dose to see if symptoms go away?  Then start a slower taper (2.5mg every two weeks)?  

thanks.

Posted 10/26/2007 10:24 AM (GMT -8)
Yes, many folks do have a recurrence of symptoms as they reduce the pred dose. It often resolves in a few days, then symptoms may appear again at the next lowering of the dose. It's also alot harder to taper as you get close to the end, in the 0-15mg range. Communicate with your doctor. He/she may decide to taper even slower or might have other suggestions for you.
Posted 10/26/2007 6:00 PM (GMT -8)
Oh yeah, a bump at a taper is pretty common. I would advise against any self-tapering or bumping of pred, it can be a terrible thing to play with. I would keep in close communication with your GI. I talk to mine at least every other week while tapering. If during that time i feel I am backsliding too much, I call.
Posted 11/1/2007 10:39 PM (GMT -8)
I agree with the advice princesa and kb5 have given. It seems many people including myself had the most trouble during tapering down from a high dose around the 20mg mark. Getting down from 20 to 10 was the hardest for me. I started on 60 and am now down on 5mg, dropping to 4 this week.

Just keep in contact with your gastro specalist. If you need to reassure yourself, ask for blood work to be done and checked. Also, just because you are getting better doesn't mean you can start eating junk food again! *smile*

Remember to keep your diet healthy and balanced. It is WAY too easy to fall back into bad eating habits as soon as you start to feel better.
Posted 11/2/2007 9:12 AM (GMT -8)
Same here...once I get down past 20mg of prednisone, I often have some of the symptoms reappear.  That's quite common with many of us. 

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