Diagnosed with Crohn's Sept 15

Pred doesn't do anything to treat inflammation, it literally just dampens it down without healing anything (unlike, say, Remicade which has been proven to heal the mucosa). People take pred because they don't want to have to live with awful symptoms for 2-3 months until their maintenance meds kick in.

I was on pred for almost the entire time in the year leading up to my surgery. It worked, in the sense it suppressed my symptoms, reduced inflammatory markers, and I was able to eat normally and stuff. But when I had my colectomy, my colon was described as having severe chronic and acute inflammation throughout. I was shocked at how there was no healing at all. No wonder I was back in hospital every time I tried to come off pred.

I'm not saying the topic creator should definitely tell her daughter to stop pred for a few days. I am saying it won't do any harm if she does: it might make her symptoms worse, but it will not make her inflammation any worse.

Hi all.
I don't know how to respond to each of you separately but will try.
When my daughter had her colonoscopy, it showed a clear rectum, and as you went farther up the large intestine, it started to show ulcerations. Going further, the ulcerations got closer and closer and then all joined together. The ileum was clear, and still healthy. She needs to have an MRI to check the rest of her small intestine. I honestly don't know what they found in the biopsy, but I think it was unclear. The GI really doesn't tell us that much unless we ask, and I don't know what to ask. I think they did NOT get a granuloma biopsy, so it is unclear. They are treating her with crohn's because the rectum was clean.
They put her on mesalamine right away. After 6 days, she was so much worse. Bloody diarrhea,( whereas before it was just plain diarrhea), bad, bad stomach cramps, and bowel movements every hour, all day, all night. No sleep at all.
We went to 3 hospitals in one week. No-one would tell us what to do. GI knew we went. No one suggested it was worse because of the mesalamine until I read all your posts. Doctors have no clue!!!!
I even phoned the pharmacist to ask their professional opinion, and they said they really couldn't say. They are the only ones that did check the side effects though.
My husband and I decided after reading all your lovely and informative posts, that we would take her off mesalamine. She was off only one day, and was feeling better, with a full night sleep. The second day off mesalamine, she started prednisone. Feeling much, much better. No bowel movements all night. We then decided to put her back on mesalamine to see if she gets worse (this was just last night). She slept all night, but is having a really bad day now. She has taken prednisone this morning for a total of 3 doses.
We had a GI appointment today. Told him we took her off mesalamine for 2 days for an experiment and was feeling better. He said he would put her on Asacol (smaller doses throughout the day). We said, but isn't this the same drug, just different dosage?
He said, fine, just stay on prednisone, and come see me in a month. She is to take 40mg for 2 weeks, and every four days, take one less pill, until finished.
I think I'm reading a lot, and also learning so much from all of you. I do feel somewhat educated with reading many websites, however, i feel the doctor isn't listening to me. Today's was all of 5 minutes. I didn't want to talk, so let my hubby talk. The GI was very short with us.
Now I am worried that the prednisone won't help and she isn't going to be on any meds that will make this simmer down.
I am at a total loss.

I will say this much: I think you're doing a good job with your daughter. I know it can all be extremely stressful, especially at first, but you're doing good by asking questions, looking up things, researching, learning, etc. And most importantly: Being her advocate. That's a great start.

It does seem you daughter very well may have mesalamine intolerance. And if that's the case, another mesalamine isn't the answer - it will cause the same problem! And another mesalamine isn't the answer anyway, because it's not a good treatment for Crohn's disease.

I think of it this way:

With UC, if you take 25 patients, mesalamines will help 15 of them, won't do much for 9 of them, and will make 1 of them worse. So I'd say it's well worth the odds of trying mesalamines for UC.

With Crohn's, if you take 25 patients, mesalamines *might* help 1 of them, won't do much at all for 23 of them, and will make 1 of them worse. So is it worth taking? I say no.

In your daughter's case, likely being one of the 25 that gets worse, the answer is certainly no.

As NiceCupofTea says, you might want to find another doctor or at least get another opinion. Most GIs are slowly but surely learning that mesalamines aren't a good treatment for Crohn's. But some remain either ignorant or stubborn.

It's good to get an MRI done to check the small bowel.

And prednisone is fine for the short term.

But a long-term treatment is appropriate in most people with Crohn's (a few mildest cases can get away without a 'maintenance' medication for long periods of time).