Update: Good idea to take prednisone with no other medication?

I have been originally diagnosed with uc 8 years ago (entire colon enflamed). To get out of the first flare, my doc prescribed 40mg prednisone and asacol. Thankfully, everything went smooth that time. Eventually I stopped taking asacol and was using only canasa and rowasa. This kept major flares away, for the most part. For the last two year I was in complete remission, taking only Canasa and herbal supplements.

Due to major stress at work, over the weekend I've experienced a bad flare with abdominal pain and 6-7 bms per day. Canasa and supplements were not helping. Desperate for relief I went to the er (long weekend) and was prescribed steroid suppositories 30 mg twice daily for 7 days. After taking them for 2 days now, I noticed no difference. Next, I went to see a gi yesterday (not my regular one because he is on vacation). The new gi prescribed 40mg oral prednisone for 16 days, lowering the dose by 10 mg every 4 days. She also said to keep taking the steroid suppositories.

I have not taken solely steroids ever before, so I'm worried. Is there a possibility of becoming dependent if you're taking only prednisone? Should I also use canasa? I'm also worried about steroid side effects, I know it's only for 16 days, but still... Anyways, apologies for any spelling and grammar errors. All advice is appreciated!

Update: called my gi, she said she gave me steroids to get me out of the flare, but I need to work with my primary gi to get a long term treatment plan. (He gets back next week.) For some reason she refused to give me prescription for any orals or rowasa canasa. She said I should be fine taking steroids for now, and will get another prescription while still tapering from pred. I don't know what to do.... I'm thinking I might try and wait it out... I am really scared to take prednisone.

Post Edited (Katerina-b) : 9/7/2016 8:36:26 AM (GMT-6)

Your GI should have RX'd a UC oral med along with oral steroids so just steroid RX was not standard protocol as far as I know. Perhaps because you have not been using an oral RX they did not want to change things without a colonoscopy to determine which oral to RX. Just guessing.

Call back to your GI and try to get an explanation. Use mesalamine enemas (Rowasa) in addition to steroid enemas in the meantime, those will not hurt and could help.

It is a little odd that you were advised to take only steroids without some other medication. Normally steroids are used as a quick fix to get really bad symptoms under control and buying time until the other medication - the ongoing maintenance medication - takes effect. Without that additional layer of medication, I would expect your symptoms will return as soon as you taper or stop the steroids.

As to the side effects, it is well documented that steroids have horrendous impacts - sometimes worse than UC itself. For that reason (and to avoid the side effects of immunosuppressants), when mesalamine and enemas did not work I elected to have surgery.

Two GIs I consulted were frank about the dangers of steroids. One did not prescribe steroids to any of his patients because of the dangerous side effects. The other GI told me that steroids would not get approved today because of their side effects - but still gave me a prescription (I never took the drugs and instead found myself a surgeon)!

Steroids are best avoided if at all possible .... there's a reason they're called the "devil's pill"!

GC4249 said...
It is a little odd that you were advised to take only steroids without some other medication. ...

Except for that prescription called Canasa.

Hair loss is often a delayed reaction to a uc flare (due to low vitamin B, D or low iron levels/anemia). Hair loss is listed as a symptom of ulcerative colitis (even without medications) and for every class and type of medication (all of which have different mechanisms of action and active ingredients).

I'd try the oral medication again, especially since you're flaring.

Thank you all. I think I'm leaning toward taking pred after all. Don't want it to get super bad.