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"Short" course steroid treatment?

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Ulcerative Colitis
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Posted 3/15/2010 11:39 PM (GMT 0)
Hello all. I am looking for some advice about the dreaded prednisone.
I am reluctant to go on prednisone for many reasons, but I particularly dread the three-to-four month "commitment" I will have to make once I pop the first pill (for some reason, I have a lot of problems with side effects when tapering, so I have to taper pretty slowly).
I am taking Entocort and started Rowasa (thanks quincy for the suggestion!), but I am not sure they're going to be strong enough to put me into complete remission. So... I was wondering:

Is it possible to take a short course of prednisone for UC like one does for poison ivy, etc? If so, has anyone done it and what were your results?
Thanks!
B

I just added a title to your post.

Post Edited By Moderator (Red_34) : 3/15/2010 7:13:45 PM (GMT-6)

Posted 3/16/2010 12:12 AM (GMT 0)
My GI had suggested a "short course" to me at one point, but I never found out what he meant..... I negotiated with him and did cortenemas instead. It took a while but I did get out of the flare.
Posted 3/16/2010 1:23 AM (GMT 0)
All of my courses were only like a few weeks/a month long. I didn't know that was short at the time lol. It worked for me. The only reason I was on it multiple times was because Asacol wasn't doing the trick.
Posted 3/16/2010 1:27 AM (GMT 0)
ElephantPipe,
What was your highest dose and how quickly did you taper?
Thanks!
B
Posted 3/16/2010 1:32 AM (GMT 0)
I started out at 40 and... I dunno, my doctor made the charts, I'd have to ask my mom. It was a few years ago. But I'll get back to you asap. I feel like I might've gone down 10 a week, but don't quote me on that. I'll double-check. =)
Posted 3/16/2010 5:36 AM (GMT 0)
Generally, short-course steroid attempt wouldn't really work with treating IBD...the key in general is to start on a high dose to get some real action from it, then of course you pretty much have to taper slowly from it, so it really just wouldn't work, safely or properly.

:)
Posted 3/16/2010 7:02 AM (GMT 0)
Hi
I am on my second short course .... I was really poorly last year and it helped alot but didnt put me into remission, I have just started a new course ....

40mg for 14 days, droping to 30mg for 7 days then every 7 days dropping 5mg so it lasts for 8 weeks.

Hope this helps x
Posted 3/16/2010 3:45 PM (GMT 0)
Well, I honestly don't know if it would work for you, since you say you have to taper slowly. I believe that for poison ivy, they start you at a pretty high dose, then drop quickly.
Posted 3/16/2010 4:10 PM (GMT 0)
Entocort is a steroid so you would be taking double the amount which doesn't make sense to me. I don't think I'd want to be on Entocort long term (more than 4 months). What are your other treatment options?

Sue
Posted 3/16/2010 4:19 PM (GMT 0)
I'm with sue. You wouldn't be on entocort and pred at the same time, and when I was taking entocort and started pred they had me stop the entocort. Anyway, most of my courses have been fairly short, though this one is about 3 months owing to being on 40 mg for nearly 3 weeks...

Like ElephantPipe, I've had to be on pred mostly cause the 5-ASAs don't seem to work well for me. I've recently started azathioprine so I'm hoping that keeps me in remission.
Posted 3/16/2010 6:29 PM (GMT 0)
I had a short course work very well for me the last time I had a mild flare. In my experience, it would depend on the severity of your flare and whether or not you're doing other things to help support your healing.
Posted 3/16/2010 6:43 PM (GMT 0)
The course of pred my husband had for poison ivy was 60 - 0 in 10 days.
It might be longer depending on the severity.


bhb....Can you not use any oral 5ASA meds such as Asacol or Apriso or Lialda..etc in conjunction with the Rowasa?

Have you had any improvement with the Rowasa so far....and how long have you been on them?

I would think that if you're improving, maybe it would be best to go to other meds before requesting the pred. There's no guarantee you will get into a solid remission with them.

q
Posted 3/16/2010 8:04 PM (GMT 0)
There have been some threads about this before, usually when someone was prescribed a short course of pred by their regular doctor who knew little about UC, rather than a GI. It won't work, was the general consensus.
Posted 3/16/2010 11:19 PM (GMT 0)
Your body produces 5-10 mg of cortisol daily for inflamation. It takes a long time to get them to produce once they shutdown, but it takes a while to shutdown too. I like to use 40mg to jump-start me out of a flare. That happens right away and then I can chop it down considerably but you never want to chop it when you get near 5-10. At that range you need to walk it down carefully chopping your tablets into quarters and you may need to go back up a little before you can continue down.
Posted 3/17/2010 12:57 PM (GMT 0)
Thanks everyone for the replies. I figured a short course wouldn't work too well, but it can't hurt to ask, can it? I am currently taking Apriso (and have been for a while), Rowasa, Canasa, and Entocort and the combo doesn't seem to be working.

I am getting desperate b/c I am finding it very difficult to get through work, but I just don't want to take Prednisone again, which the doctor indicated would be the next step. I took it, starting at 60mg, last year and it took me a long time to recover from the side effects. In fact, I was just feeling better when I started to flare again.
I vowed I would never take it again, but I am now wavering as the pain and exhaustion is pretty bad.
Thanks so much for your advice. I think I am going to contact my GI today to discuss options.
Bridget
Posted 3/17/2010 2:37 PM (GMT 0)
I know what you mean. Just as you start to feel good, here comes another flare. I've had good luck with Entocort -- it takes longer to work but the side effects are much less than with prednisone. I am also taking Imuran (azathioprine) 150 mg/day. I'm not sure how well that's working for me anymore. It seemed to work early on, but not so much anymore.

I have learned that the key is taking action as soon as I begin to flare. The longer I wait, the greater the chances that I will have to go back on steroids to get back into remission. If I catch it early, sometimes just the enemas, or avoiding certain foods will work for me.
Posted 3/19/2010 2:53 AM (GMT 0)
Hey there. I may be an exception but I did a short course (40 to 0 in two weeks) and it put me into remission. That flare was a postpartum flare and it was the worst I had ever had (I was running a low grade fever for the first time, bleeding profusely and in significant pain). Also that course was prescribed by my GI doc not a family doc. Could be worth a try and if it doesnt work you just up your dose and go for the long haul.

jo
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