Posted 11/3/2007 6:04 AM (GMT -6)
I guess everyone is different, I do believe that it is important to get a flare up under control as quick as possible, you dont want to get any sicker or more run down than you have to. Take care Lulu x
Posted 11/3/2007 7:34 AM (GMT -6)
I have never been on pred in the whole 15 years that I've had this because my GI is one of the few (from what I have learned on here) that refuse to put his patients on pred unless he absolutely has to. I was down to the wire last year when I was in a highly resistant flare and he almost put me on pred to calm it down but luckily we decided to wait it out with the steroid enemas instead.

But I agree that it's prescribed too fast. Sure it can help settle a flare quickly but the long term affects of this med can be somewhat scary. Short doses here or there may not be a problem but many Uc'ers need the long term treatment dose to get their flares under control. That in itself can lead to possible complications outside the GI tract.
 @--->--SHERRY--<---@
Left sided Uc -'92 - Colazal, Canasa, 6mp, Prilosec, Biotin, Forvia, Pro-Bio 
Allergies - Singulair, Astelin(got the script - just haven't tried it yet!)
Secondary Reynauds Syndrome - '04 - Norvasc
Fibromyalgia - '06 
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Posted 11/3/2007 8:10 AM (GMT -6)
It's a moot point for those like me that cannot tolerate any 5ASA drugs whatsoever and don't go into remission on imuran or 6MP. I do have alove / hate relationship with the stuff because it (pred) is a 'wonder" drug for me but I also know how toxic it is long term, so if TSO or hookworm or something doesn't get me into a long remission I will have to ditch this colon once and for all.
Pancolitis dx'd 1986, full med-free remission 88-97
Flaring or simmering ever since
10 20 17.5 mg pred, 100 mg Imuran
Probiotics (Primal Defense and others), TSO
Turmeric/circumin, fish oil, many vits/minerals
Low-carb version of Specific Carb Diet
 
 
 

Posted 11/3/2007 8:26 AM (GMT -6)
I agree that pred is a mixed bag.

I had such a hard time getting off of pred the first time (took about three years of tapering and raising) my gi left it up to me if i wanted to try it again. I did because my graduation was a week away and I wanted to walk the stage. I am steroid dependent now so after I get through this flare my Gi won't use it again. But it did allow me to get through my graduation in Feb so i have to be grateful. This drug has done terrible things to my body and mind over the past ten years. Now at 15mg i am unable to lower my dosage at all without flaring. I've been here about a month and can feel my body slipping backwards again.

Now i have the problem of if imuran doesn't work (its been about three months and i am having more symptoms than before) I don't have pred to fall back on. My Gi wanted me on Remicade becuase it has been shown to show resultsw faster than imuran, but my insurance wouldn't go for it.
Kelly, 29

Left sided UC diagnosed 1/98 age 19, Pan colitis diagnosed 1/07
Currently on 4x3 Asacol, Rowasa every other night, 15 mg pred. until immuran kicks in...
75mg Imuran starting 8/23/07---bumped to 100mg 10/8/07
Prontonix once daily for acid reflux, zofran twice daily for nausea

Posted 11/3/2007 9:28 AM (GMT -6)
Kelly, that's how I ended up on Pred also. After a year of juggling all the other treatments, I was down to a choice of Pred, Remicade or surgery. Remicade wasn't yet approved, so the insurance wouldn't cover. I wasn't ready to take a step as final as surgery. So my choice was the Pred or to continue with a life that at that time wasn't worth living. I was literally on the toilet 20-25 times a day with heavy bleeding and pain.

I agree the Pred should be reserved for treating bad flares that don't respond to any other comination of treatments. It just has too many negatives to be used simply because it's quick and easy.
Judy
 
Left-sided UC diagnosed 2001.  Taking Colazal and Imuran, Remicade infusions and moving into remission. Finally off steroids after four years! 
 
Now in remission for almost two years. Remicade has been my wonder drug.
 
"If you spend your time second-guessing your past decisions, you'll never have time to enjoy today."

Posted 11/3/2007 11:56 AM (GMT -6)
In my 16.5 yrs of dealing with crohns-colitis being on and off pred many times, I can say that for me it's no longer affective so there's no guarantees with it either.

:)
My bum is broken....there's a big crack down the middle of it!  LOL  :)

Posted 11/3/2007 12:01 PM (GMT -6)
I don't believe that prednisone should be a long-term treatment. When I see folks on pred for months at a time -- that's a scary thought. I think prednisone should move you from flare to remission, while also starting you on Asacol, Rowasa or whatever is your long-term maintenance medication, and then it's time to get the heck off of it. It's wonderful to bring inflammation under control, but the long-term side effects are truly awful. So it's wonderful/awful.

Mitz
Sporadic proctitis since about 1985. Mother had J-pouch surgery 1983.
DX'd with clostridium difficile in 2000. Pred, two courses of Flagyl, then Vancomycin finally got rid of it. 2001 colonoscopy dx'd left-sided UC. . Treated with prednisone, Rowasa, Asacol. Asacol not working, switched to Imuran. Three small flares since in 2002, 2005, and 2007, brought under control with steroid and Rowasa enemas. Lap Chole performed October 26, 2007, after gall bladder attack in June, '07.
Daily meds: 100 mg Azathioprine and 225 mg Effexor XR (for chronic, longstanding depression), many vitamins and Primadophilus Reuteri

Posted 11/3/2007 12:06 PM (GMT -6)
I personally suspect...but have absolutely no proof....that pred used initially can set up failure of 5ASA meds. It could be just that expectations is the culprit.

q
*Heather*Status:mini flare June 23* 6asacol daily+ Salofalk (tapered every 4th night)
~diagnosed January 1989 UC (proctosigmoiditis)
~5ASA: Asacol + Salofalk enemas (increase for flares tapered to maintenance)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals 
~Probiotic 2 (Natural Factors Protec) + 1 (Primadophilus Reuteri) at bedtime
~Natural Factors Multi Digestive Enzymes with supper
~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 !!!

Posted 11/3/2007 2:51 PM (GMT -6)
I agree that Pred should be reserved for severe UC. It saved me within hours at 40 mg/daily when I was near blockage on the left-side. My gastro had me tapering after 8 days & I was able to get off it at the end of 3 months. This happened 12 yrs after my initial diagnosis & was the only time I had to take it-- so, my feeling is that if you're in crisis mode, take it to avoid worse. / Old Hat (nearly 30 yrs with left-sided UC;currently on 3 Colazal daily;seem to be back in remission)
Posted 11/5/2007 10:46 AM (GMT -6)

I do think it is over prescribed

I have been on pred for 4 years and am steroid dependent.  I have tapered down to 6mg now but I cannot get completely off it.


Back on Pred - 8mg - Steroid Dependent :-(
Azathioprine 150mg
Actonel 35mg
Predfoam Enema
VSL #3 with Activia Yoghurt
EPA Fish Oils
Various Homeopathic meds
Asacol x 9
Remicade every 8 weeks  (Stopped working)
Aloe Vera Lily of the Desert Juice  Gave me the worst D !
Primadophilus Reuteri Probiotic
Prograf Tacrolimus 4mg
 

Posted 11/5/2007 11:48 AM (GMT -6)
They put me on Prednisone 2 months after being diagnosed and I have to say it did wonders in the beginning for me. The side effects were a small price to pay(in the beginning) for being able to get out and do stuff. If it wasn't for pred I wouldn't of been able to go to Prom. After a while it cost me a lot though(relationships and friendships due to severe mood swings even), so thus I rule it out as 50/50 for being worth it.
Diagnosed with Severe Ulcerative Colitis 1/04 -(18 at the time)
11/04 Total Colectomy
2/05 Ostomy Takedown
1/06 DVT In leg
5/06 Pulmonary Embolii
4/07 Another DVT In leg
Current Medications -
Vicodin 800mg when needed(yumyum)
Coumadin

http://www.myspace.com/mrsnuts/
http://www.livejournal.com/users/mistersnuts/

Posted 11/5/2007 12:13 PM (GMT -6)
If I could do it all over again I would never have used Prednisone.... the side-effects weren't worth it in my opinion. There are more effective meds than Prednisone.

I think one of the issues that is over-looked with Prednisone is that it makes it more difficult for J-pouch surgery. It weakens your muscles which makes surgery more difficult. I met with a CR surgeon last month and he told me that I should be able to have a 1-step laproscopic J-pouch surgery because I haven't been on Prednisone in a couple of years. Otherwise I would have to have the 2-step J-pouch surgery and wear a bag for a couple of months between the first and 2nd stages of the J-pouch surgery. And who really wants to have to go for 2 surgeries when you can go for just one surgery.

--Keith
DX'd with Pan-Colitis June 2005
Current Status: Flaring since May
 
Current Meds:  50 mgs 6-mp, Colocort, Oral Cyclosporine (500 mgs)
Supplements:  None 
 

Posted 11/5/2007 3:54 PM (GMT -6)
Hi - Prednisone was a life saver for me. Speaking of underweight, at 5'6", I was down to 108 pounds and couldn't care less if I ate or didn't. My GI put me on 20 mgs of pred (to start for 12 weeks) for the sole purpose of revving my appetite, which it did!! Then when I got my appetite back normally, he tapered me off very gradually 2-1/2 mgs at a time for 10 days each dose until the end. At that was the end of it. So...the only purpose, he said, for the pred was to help me regain a normal appetite and then get off it as quickly as possible.

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