Last day at 10 mg prednisone.... Advice?!

Hi all,
First and foremost, this forum has been a god send to someone newly diagnosed. So I thank you for your wisdom and taking the time to read and respond to my post.

Background - I was diagnosed on April 20, 2017 with ulcerative proctitis. On my c-scope, GI said the inflammation was moderate and everything above the sigmoid came back normal with no inflammation on my biopsies.

I was put on a very short course of prednisone, rowasa, and canasa. After symptoms (1-2x daily blood/mucus) returned at 15 mg on the first round of prednisone, I had to bump back up to 30 mgs until I was stable. Currently, I'm on my last day at 10 mg. I noticed that when i got down to 15 mg of pred this time, I did see trace amounts of blood that disappeared after 2-3 days .... same thing happened when I lowered to 10... but again, I'm back to normal now. Typically I have 0-2 BM's daily with traces of blood when tapering. Urgency is improving, but I can't hold it all day like I could before my diagnosis (I never thought I'd miss those days!). I'm still a little gassy and rumbly in the morning... not sure if that's from the rowasa or UP.

My questions for all of you is-does it sound like I'm nearing remission, or is it the prednisone? I've been using the rowasa and canasa daily for these 8 weeks also. Is it wise to drop from 10 mg to zero? That's what my GI said to do. He did mention that I could try a steroid enema or suppository if I see some symptoms return when off the pred. Has anybody had success with that instead of the mesalamine rectals?

I really want off the prednisone and can't help but feel that at this point if I'm going to relapse, why delay the inevitable?

I know UP can be unpredictable, so any feedback is appreciated.

quincy, thank you for your feedback. In your opinion is a 10-0 pred drop a bad idea because of symptoms of withdrawal, symptoms of UP returning, or both? My GI gave very little direction in this department. Good to know the morning rumbles are normal with the enemas.

I inquired about the oral mesalamine as well, but my GI seemed to think that it would be pointless. He said the enemas would provide enough coverage. I have an appt on the 23rd with another GI for a second opinion.

Good question about the "short" course of pred, but this is what my script was:
40mg-5days
35mg-5days
30mg-5days
25mg-3days
20mg-3days
15mg-3days
10mg-3days

From what I've been reading, this seems like a fairly short course??? I didn't stop seeing blood until I was a good two weeks in to the schedule.

I don't feel that I'm sensitive to mesalamine, and I'm 100% open to taking it orally as well if it will benefit me.

Yes, been on pred , enemas, and supps since April 20.... Not sure what this means as far as my prognosis. GI started mentioning biologics, which I'm also not entirely opposed to if need be, just trying to educate myself and make the best decisions for my health.

but by the same token, I don't trust my GI at all.... he's said a few things that I found were "off", and has even called me back after my appt to tell me that he was wrong, and that I was right! Big gulp on his end, but I respect the fact that he called to admit he was wrong. I have two upcoming appts. with two separate GI's.

10-0 is tough. I would suggest splitting your pills when you drop from 10-0 and alternating 10-5 (or even 7.5) and then 5-2.5. Somehow the tail end of the taper is always hardest for me. My doctor had me also take 2.5 every other day for a week, but I was on pred for 3+ months. Good luck!

If you've been on a short course of pred for 2 months or lessthan a 10mg to zero drop is fine. Could it be gentler? Absolutely. For peace-of-mind, you can go slower. Half pills work for gentler drops (drop from 10mgs to 5mgs, then drop from 5mgs to zero). You can get a pill cutter inexpensively at most pharmacies. Or use a razor or exacto-knife works fine too.

Most of us feel wonderful on pred, but we've got to sustain without it. We're all anxious during taper as there's the possibility we could get worse during that taper. There's no knowing.

You can throw all of the steroids in the world at a flare for temp relief, sustaining without those steroids is the real trick we all need to pull off.

Holding it a whole day without pooping lol, haven't done that since 2011 before my diagnosis. I've been in a remission and i still need to poop within the hour. I get made at my wife when she says: she doesn't have time to poop, sensation goes away and that's that

1. a product called Adrenal Fatigue really helped me on the last taper. You can get it on Amazon. Try to figure out your crash time and take it then. For me, my adrenal glands started getting wonky around 5pm.

2. Warning friends and family that you are coming off pred so they can be supportive. I am usually a pretty steady person but pred tapers always made me CRAZY.

3. Doing it slooooooowly. I split pills down to quarters.

Thanks ipoop for your response. It's easy to panic over every little symptom, and there's an obvious learning curve that will take some time for me to figure out.

I am off of prednisone as of a few days ago, so my only meds right now are Rowasa and Canasa, and I had my appointment with another GI. Since being off pred, I've had traces of blood here and there. No increased frequency or urgency, and it doesn't seem to be getting worse. Still having 0-2 BM's daily. It's a little frustrating because I'll have zero signs of blood one or two days, but then the next there's traces again.

The new GI prescribed 4 Lialda daily, (haven't started taking yet, just got the script filled) and wants to see me in 4 weeks to discuss my progress and have another colonoscopy to see how things are looking.

In your opinions, is another colonoscopy necessary? I don't mind doing it if need be, but I was thinking a flex sig would be sufficient considering my colonoscopy in April showed zero inflammation above the recto-sigmoid junction.

Thanks again ipoop... will be taking the lialda starting tomorrow. And yes, this GI did order both stool and blood tests. She's being more thorough than my previous doc. Not sure if it's an FCP stool test though, but I will inquire.