Long Term use of Entocort?

Hi BTM

I understand your dilemma. It's one many of us who have gotten terrific symptom relief from steroids have. I've had crohn's for over 30 years and the only drug that has ever really eliminated my symptoms is prednisone. With every other medication I've tried, there's a compromise involved. I may feel better and the disease is manageable but I live with symptoms every day.

When I get really sick and end up in hospital on IV steroids, there's almost a sense of relief. Even though it's always when I'm at my sickest I know that soon I'll be taking a vacation from crohn's. Then as the steroid taper starts, the pain, tenderness and other symptoms start to creep back into my life.

But here's the thing. I have watched people die who had been on steroids for long periods of their lives (at a time when there were few other opportunities). In one case I was in a bed next door to a woman who was dying (not from crohn's disease). Now, the steroids didn't exactly kill her, but ... after 35 years of relativelyl regular steroid use, she had severe osteo-arthritis that was only controlled by heavy, heavy morphine injections. She had diabetes and gangrene in her toes. Her heart was failing. There is no question that, while the steroids improved her quality of life for many years, eventually they were a significant factor in her death at a relatively young age (late fifties).

That experience of listening to the suffering she experienced in her final days has stayed with me, even as i have succumbed several times to the temptation of staying on steroids longer than advisable. But at least I understand why my doctors get so testy when I start begging to be allowed to have a short steroid course.

Entocort is a lot safer than prednisone. You probably already know that. The steroid acts directly on the bowel instead of systemically through the bloodstream, so many of the effects associated with systemically delivered steroids are lessened, but there still is a risk.

You have to weigh that against all the other options.

If it were me, at age 52, I'd probably stay on the entocort if 3 mg kept me in remission, but if I were a teenager or in my 20s, I'd probably make a different decision. The reality is, if you take steroids long enough at a high enough dose, you will almost certainly suffer side-effects.

The other thing to consider is this: I don't think steroids treat the underlying disease, they only mask symptoms by reducing the body's inflammatory response. The disease is most likely still active, just not causing symptoms.

You need to thoroughly thrash this out with your physicians. Make sure you really understand the pros and cons of all your options. There won't be a perfect solution, but there should be one that you can live with.

Keep us up to date

Beth, often it's a matter of trying every med available until you find something to work for you. A bad reaction to 6MP doesn't necessarily mean that you won't do well on methotrexate, antibiotics or one of the biologics. This is a long-term process and it takes a long time to find something that helps.

I think Belleenstein has given you some superb advice. Steroids are great, but really aren't good for people when used long-term.

Welcome!

Ivy.