Worried about my husband taking Prednisone

Hello everyone, my husband is 34 years old and in March 2014 was diagnosed with Chronic Ulcerative Colitis. His doctor prescribed him first mesalazine, both enema and pills, after 10 enemas, he started with supossitories, it took about a month for him to feel better and then the bleeding stopped. Now after 4 months he started bleeding and feeling discomfort (he feels bloated) again and the doctor prescribed Prednisone twice a day 10mg (I'm not sure about the amount). The doctor said that it was a short period of time to have a relapse, and that is why he decided to change the medication. Has anyone have experience with prednisone? I really need some advice about what to expect and how his diet should be. Any suggestions about how to improve his inmune system? Thank you.

I don't think a course of prednisone is a terrible idea for someone who is flaring, the problem is that prednisone alone rarely stops a flare in its tracks long-term. It stops it while you're on the prednisone. You have to look at pred as a bridge to get you well enough to start another medication that you will take for maintenance. What is the medication your husband is going to use to maintain if the mesalamine isn't working for him? That is what you need to find out.

20mg of pred a day for a short course isn't a high dose, usually people end up on it a bit longer than expected - it has terrible side effects for a lot of people, weight gain, bloating, poor temperament, anxiety, acne... Most of the time people with UC start at 40mg and taper over a month to 2 months (sometimes it ends up being much longer). You need to plan for after the course of prednisone. Maybe he will stay well with mesalamine, but he may not, if mesalamine were controlling things, he probably wouldn't need the prednisone. Can he try rectal enemas? Those treat a larger area. They have steroid enemas too, they may work better if mesalamine is not effective for him - can't use those long-term either so you would still be in the board of finding something for maintenance.

I'm very sorry you and your husband are having to deal with this. It's not a fun desease, but most often it can be managed well.

Is he still on some sort of renctal med ? My suggestion would be to get back on the enemas because while they are not the most convenient, they are the most effective.

I agree with Andrina regarding the Prednisone and the Immune system.

Diet is important, but it can be a real challenge to figure out. Try to focus on the meds for now, but if you do try to make any changes, do them one at a time so it's easier to know what is working and what is not.

Good Luck !

Are you seeing a gastroenterologist or just your primary care physician? The pred treatment sounds a little odd to me. 20 mg/day isn't very much and I'm not sure it's enough to knock out a flare. Prednisone should never be a primary maintenance medication -- it's a rescue drug only. Is he still taking mesalazine? How much and what brand is he taking? He needs to stay on oral & rectal drugs for life -- even when he has no symptoms. Once he is in a solid remission he may be able to lower the dosages, but he will need to always be on meds.

I drank tons of water when I was on pred and was able to avoid the weight gain side effects.

Not sure about the pain in his knees. I get pains sometimes, but I suspect that mine is related to getting older

Hi CCinPA, my husband's doctor is a Gastroenterologist. My husband is still using Salofalk supossitories (this is a German Brand) mesalazine 500mg. The doctor said that he can use it while taking Prednisone. We are from Ecuador, living in Quito, and there are not many patients with OC here. When the doctor prescribed Salofalk Enemas we had a very hard time finding that medicine. I hope that the prednisone helps my husband but I think that he needs definitely other medicine as a long term treatment.

Is he still taking oral mesalazine? What dose and how many pills? I ask because I often see people here taking very low doses of oral meds and they often flare. In my mind you should take the max dose until you are in a solid remission for several months and then you can lower, but never stop, during remission

Definitely talk with your doc. Best treatment for UC is both oral & rectal meds.

Thank you Dikid. I'll keep that in mind.

I also find 20mg a low dose. I have got into remission from 30mg from a not too bad flare. Also, here the advice is usually to take once a day early in the morning. Splitting the dose is probably more disruptive to the adrenal glands. You can find some best practice guidelines if you look up the American Society of Gastroenterologists

i wouldnt be worried about him taking prednisone. im 17 and i was on 60mg for like two months then tapered off. the only problems i had was that i was always hungry for anything and everything and then i gained some "fake fluff" (it only stays as long as you take it) but my face was super puffy and i had gained back some of the weight i lost before my diagnosis (in june 2015) but thats just because i really did eat anything and everything. just make sure he takes it super responsibly and dont mess around with it, for it is a serious drug