Prednisolone, my dr wants me to start - has anyone had any good reports on it? Does it work?

Prednisolone (which is the same thing as prednisone) does wonders for getting a flare under control for most people.  For myself, I only take it as a last resort because of the side-effects, but not everyone has the same reactions to pred.  If you've never taken it before, give it a try, but educate yourself about what it is doing first.  Do some research online, and be sure to read all the literature that comes with the prescrip.

If your colitis is mainly in the lower part of your intestine, you might try a rectal med with hydrocortisone, or even a pred enema.  You get the benefit of the pred without the nasty side-effects.  They generally only help colitis lower down, so if you have colitis going up the left side, or extends more than 10 to 15 cms, rectal meds might not reach far enough to help.

I have taken pred before and successfully tapered off.  I was then off it for a year, and my symptoms didn't return until I stopped taking Asacol and a full on flare started.  Pred is a wonder drug for me...it gives me a stomache of steel, where I can eat whatever I want with no problems, and my symptoms go away within a few days.  The side-effects I don't like are the insomnia, faster hair growth, back-ne, increased appetite, and mood swings.  That is a pretty daunting list I admit, but those effects are more manageable than constant D, bleeding, and getting cramps from gas.

I think most people will say they have benefitted from pred, but they didn't tolerate the side-effects well.  You have to weigh the advantages of getting your UC under control against the possible bad stuff from pred.  I hope this helps you.  If it were me, I'd give rectal meds a try, maybe add in a probiotic, before taking the pred, but don't discount it all together.  If your flare is interfering with your life a great deal, pred might be the thing that helps you regain control.

I don't think it's as simple as just saying "don't take it".... I know personally, pred was the only drug to get me into a remission while badly flaring. And the first course I took, I was on 60mgs/day, & was able to taper successfully with little side effects. There's nothing wrong with taking steroids... they are the gold standard for inflammation control for MANY problems. It's when you find yourself having to do repeated courses, or unable to get off them, when the problems start. To be honest, having had zero personal experience with prednisone, quincy, I don't see as how you're qualified to tell someone whether or not to take it. I know you've had great success with just 5asa's, but most people don't. They only induce remission in mild to moderatley active UC, bottom line- in moderate to severe UC, generally steroids are used in conjunction with 5asa's. Once remission is achieved, the steroids are tapered & the 5asa's are continued to be used as maintenance. For an individual with severe or refractive UC, to tell them NOT to take steroids is completely remiss. You look at any/every study done on drug therapies used in severe/refractive UC, steroids are first & foremost what is prescribed. So I agree with the mindset that once the decision has been made that steroids are needed, take a heavy dose ASAP & your chances of inducing remission with the least amount of side effects/complications are the greatest. I loved that first course of pred... I hated it by course 3, but that's another story! And by that time, we had chosen to move onto heavier meds to get off the steroids. And I have been steroid free since February. Would I go pred again? Yeah, I'd give it another go-round- at least once. Personally I found the side effects to be worth the beneficial effects of the med, when it works as it should.

yeah, I did go on Remicade to get off steroids, & because the inflammation was very bad & uncontrolled with the steroids- when I started Remicade I was on my 3rd course of pred. If I were to flare severely again, there are very little med choices left- possibly Humira? Then it's surgery. The Remicade has helped tremendously, but it has not put me into a clinical remission. So I plan to remain on it until it no longer works, or until I do flare badly again. If that did happen, if I started to go into a bad flare, I'd give another round of pred a chance, see if it put me back into remission, & most likely give Humira a try if I could get insurance coverage. So if I'm looking at a choice of trying pred one more time, or going straight to surgery, then I'll try the pred. This is all assuming the Remicade stops doing whatever it's doing. I would not do numerous courses of pred, but one more try for old times sake!

Sorry for not replying straight away, but i was just reading and digesting all your replies. Thank you so much for taking the time to reply to my thread and offer me advice!

I have my meeting with my Dr this PM. I have made the decision not to begin Pred as i am very concerned about the sides, both short and long term. I am on life long medication for another disease that is much more serious than UC, so i dont want to rock the boat so to speak.

From what i understand, when you have Pan Ulcerative Colitis, then rectal meds wont do the job as they dont reach far enough. At the moment i am on the 5 ASA's in the form of Asacol (800mg 3 x day). Although they have reduced my BM's i still have diarrhea/loose stools each time. However, im not passing blood or loosing any weight.

I know the reason my dr wants me start on Pred, is to hit hard and early and then maintain with Asacol, but i think that if the risks outweigh the benefits then there's no logic to it. I would rather cope with diarrhea 5 times a day for the rest of my life than deal with additional health problems such as bone death etc.....from the pred.

I will ask my Dr what the risk is, if i continue to have diarrhea every day. Will it increase my risk of colon cancer etc?

The one option regarding pred is to do aquick 10 day taper.....

If you're willing to share, what liver disease is it that you have?  Is it UC related?  I have PSC...UC-related and am using URSO to hopefully help decrease acceleration.

Keep us updated about your dr. appt.

quincy