Should I take prednisone for my first (mild) flare?

Hi, I'm new to the forum and new to UC. I haven't been "officially" diagnosed (my colonoscopy is scheduled for 6/12 along with endoscopy to check for celiac). My doc put me on Asacol, but I was reading that it may take a month for it to start showing any noticeable effects. I emailed my doctor and asked about prednisone to kick-start things... she agreed and called in a prescription for 40 mg.

Then I started really researching and am learning about all the side effects. If my symptoms were really severe there'd be no question (and I'm sure she would have prescribed it right away.) So I'm wondering based on the experience here in this forum whether you would or would not take prednisone if you had the following symptoms:

- reasonably healthy BM in the morning, sometimes a painful non-BM (just blood) if I ate the wrong thing
- always some blood in stool, and always small amount of the runs every time I pee
- I don't have to run to the toilet all the time... once or twice a day (if I have to fart I generally run to the toilet for fear of "sharts" but fortunately that's not very often)
- Some crampiness and discomfort

I've started taking boswellia, slippery elm and probiotics, plus adding turmeric to most foods.

My thinking on taking it is that my doc told me to go back on gluten diet so they can test for celiac, but gluten does make my symptoms worse (just more blood and cramping, but still not severe.) I'm also reading that a mild flare could spread into something worse unless treated right away. But I'm leery of the possible side effects (although "moon face" generally doesn't happen until you've been on it for a while, yeah?)

Your thoughts? Thank you!

Lialda and Rowasa got me out of my first flare when I was originally diagnosed with moderate to severe pancolitis. The lialda kicked in within a week. I was then in remission for about 4 years using only Lialda. I only just took prednisone (reluctantly) 2 months ago for a very stubborn year long post partum flare. I'm glad I did it, but I would only use steroids again if I was desperate.

Rectal meds before pred for sure.

When I saw your topic, my first thought was 'no, no, no! Avoid prednisone as long as you can!'

Also, I think you answered your own question about this when you said you are back on gluten for celiac testing and you know you get symtpoms for that. If you have celiac, then the answer is to cut out gluten, not take prednisone.

Good luck with your scopes and let us know the results.

I agree that if other things work quickly, no need to use pred- however, a flare feeds a flare and its much harder to undo a bad flare than it is to nip one in the bud, so if the non steroidals dont work by all means use pred. I dont consider it a devil drug at all- it is a powefprful flare sgooper and indeed its power is especially great if one hasnt been on. The side effects have never bothered me that much- even moonface is mild for me, but I know it throws some for a loop. Decades ago a few bkuts kf on and kff again lred got me intk a ten year med free remission. Granted, I am allergic to mesalamines so I dont carry the hatred of pred- though I avoid it like crazy too exceot when in a nasty flare that My naturak rescue remedies dont work on. So yeah, try the mesalamines first, and if your UC is rectal or sigmoidal onky, hydrocort enemas can work too.

I started flaring last year and instead of going on pred right away I tried to beat the flare by increasing my lialda and taking supplements and diet.
I fought the flare this way for about 3 months and all it did was get worse and worse til I couldn't take it any longer and started taking the pred.

This was my second time taking pred other than my initial flare where I was diagnosed with UC, the first time the pred had the flare under control in about 3 days and I just tapered down from 40mg then lialda for maintenance.

The second flare that I waited 3 months trying to beat the flare without the pred, got really bad and this time the pred took awhile to start giving me relief and it took a long time to taper off the pred and I had to go onto Imuran for maintenance.

In hind sight I wish I would have taken the pred right away and knocked out the flare instead of letting it get so far out of control, I think it would have saved me from the long pred taper and maybe even the Imuran.

Post Edited (JHarvey) : 5/27/2012 4:53:39 PM (GMT-6)

why play devil's advocate....most everyone would have pred side effects, and some of them lasting in a forever change of something, especially if one can't get off it fast enough before the adrenal glands shut down the production of cortisol.

Don't get me wrong that it's not a miracle med...there are better meds for UC to start off with initially.

It puzzles me that one would ask for prednisone and the doctor giving it...my advice is know what you wish for.

Get on rectal meds...I would suggest mesalamine initially. Takes commitment to understand how they can work...not a fast fix. But, if you do well on them, they can be a long-term med to up for flares and taper to maintenance.

q