HealingWell
Search Close Search
☰

How long for Pred to take effect?

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/3/2011 10:02 PM (GMT 0)
All-

Searching as much as I can on this (and will ask my doc as well), but is there a usual amount of time it would take for Pred, either a beginning does or a rise in dose, to have an effect? And once it kicks in, would it's effect rise over time (and it seems like some folks actually acclimate to it, and it's effect is lessened).

After initial diagnosis, I was on 20mg (and Asacol). Saw an improvement about 10 days later (along with dropping lactose, alcohol, spicy and fried/fatty). Started getting a lot worse and upped the Asacol and Pred to 40mg 10 days ago, and nothing new to report. I know what everyone feels here about Pred, and thus far no side effects (maybe it hasn't been long enough, and I know all too much about the long term effects). I know there are other alternatives, especially rectals that I have yet to try, but wanted to get everyone's take on this.

Thanks all!
Posted 1/3/2011 10:10 PM (GMT 0)
I started on 40 mg of pred and noticed a big improvement by the next day, and by the second day, I was back to 1-2 BMs/day. I was having 10+ very urgent BMs a day when I started pred. I had been on Asacol and mesalamine enemas for a month and a half at that point (this was during my first and so far only flare), and had gotten close to remission, when a stomach bug I picked up from my son stirred things up again.

I strongly recommend you get an Rx for the mesalamine enemas. I've got to admit it's disappointing to see that your doc started you on prednisone from the get-go.

How bad are your symptoms?
Posted 1/3/2011 10:22 PM (GMT 0)
I also started on 40mg and I saw improvement right away. I was in a ton of pain and losing a lot of blood with frequent movements, many of the bathroom trips were just to relieve blood and pressure... After a day or 2, I wasn't in pain any more and I was down to normal frequency. I have had a lot of issues getting off prednisone and I had to add an immunosupressent. I think after 10 days on 40mg, you should have seen a significant improvement but I have heard of people requiring even longer treatment to get back to feeling "normal".
Posted 1/4/2011 1:04 AM (GMT 0)
I saw significant improvement within 2 days. The blood stopped and my BMs were less often, less urgency and firmer. Then every 6 or 7 days I would notice firmer stools.
Posted 1/4/2011 2:48 AM (GMT 0)
Prednisone 40 mg. turned off the diarrhea like a faucet. Never had any blood. Once I dropped to 10mg. things started up again. Definitely get on the rectal meds.
Posted 1/4/2011 3:14 AM (GMT 0)
Wow, thanks for the feedback everyone. My symptoms are (in a nutshell) soft but mostly formed stools with blood and mucus 2-3x starting within 10 minutes of getting out of bed in the morning, urgency (jog, not run) and some spasming going on, blood will taper off after the first. Then same thing in the evenings, varying in start time but usually over in 30-45 minutes. My meals are consistent, with a full lunch. Once or twice a week will have a 1-2x affair in the afternoon as well.
Need to update my sig but: on 40mg Pred, 4800mg Asacol, fish oil, multi + D, 2 packs VSL#3DS. No spicy, alcohol, greasy/fatty, citrus. Stick mostly to grilled chicken and fish, steamed veggies, whole grains. Started gluten-free a few days ago for kicks. If I do have a problem with any foods I'm on, it only came about as symptoms got worse.
Posted 1/4/2011 5:40 AM (GMT 0)
For that you got pred? wow, banging head against keyboarsldfspeot;lxzfoiSRE0I35-/

Your goal should be to stay off pred...forever!!!

You need rectal meds.

q
Posted 1/4/2011 11:15 AM (GMT 0)
When I was first diagnosed in 2009 I was given pred too. I took about a week to notice a positive effect but I did notice that I was completely exhausted and I slept almost all day and all night. I think consuming only a limited amount of processed food helps -especially carbonated drinks.
Posted 1/10/2011 4:49 PM (GMT 0)
Doc won't give me Rowasa over the phone, using same argument that it won't go high enough, going to see him today to make my argument in person (Asacol from the top, Rowasa from the bottom). Would hate to change doctors as he's been flexible so far but want to get the scrip for Rowasa.

At this point, either the Pred isn't doing anything for me, or if it is, it's just keeping me from getting worse and keeping me at this level (is that possible?).

I can see him wanting to up my does of Pred, and I'm on the fence. No side effects yet after ~2 months on 20mg then ~3 weeks on 40mg (thank goodness), but it's just too long.

>>>Is it a good time to start a Pred taper, or, for kicks (Quincy- not in the face, just a figure of speech :), I agree there were alternatives to begin with), since I'm on it already, see what happens on an upped dose for a week?
Posted 1/10/2011 7:28 PM (GMT 0)
what exactly are your symptoms?

Tell the doc that you know that the enemas are not made to go throughout the colon, but they do get into the entire sigmoid.  Considering UC starts at the rectum, it all makes sense to try them.

And... you want to use them to be proactive and hopefully not have to use the pred in the future. You've not been given that opportunity, which is frustrating for you.

I don't know how I'd handle it because my butt is already twitching at what a dork your doc is being..sheesh.


I suggest you get off the fish oil for a while.,,I personally think it can cause some urgency regarding how slippery it is.

You know..I just started Chia seeds again...good source of Omega 3...and so far no slippery butt...just as an aside and a possible suggestion to replace the fish oil.

Regarding tapering the pred, you can alternate when you get to lower dosages.

q

Posted 1/10/2011 8:03 PM (GMT 0)
I don't think it's good to taper if you're still having a lot of symptoms. At the same time, if it's not doing anything for you, you need to do something... I would recommend either going up to try to knock out the flare or getting other medication to help control the symptoms. Has your GI mentioned 6mp/imuran? If you're going to go that route, you should do it before you've been on a high dose of pred for a LONG time. I didn't have bad pred side effects until I started tapering. In the first month or so, I thought I was in the clear and would get on and off without side effects. Unfortunately, I ended up on for longer than I wanted, had to start over at 40mg after a relapse at 2.5mg... not good. You need to make a decision, what's the next step? Can you live with these symptoms? Would they become unbearable if you tapered off the prednisone? are you ready to try more powerful medication?
Posted 1/10/2011 8:45 PM (GMT 0)
Short of a sinus infection/antibiotic couple of weeks in December, my symptoms are certainly bearable. 3-4 spasming BMs every morning, mostly soft to decently-formed over the course of 30-60 minutes, lots of blood and mucous, and if I'm sticking to my diet plan, I may get away with zero to a few pink mucous squirts later in the day and that's it.

Q- I've actually been using chia seeds in my mornings oats; it adds a great taste and lets me get away with even less sugar :) Won't let the doc know what you called him but I hear ya :)

I would really prefer not to go to a 6mp/other immunomodulators if at all possible. If I live with these symptoms for an extended period of time, well, it's certainly not the worst thing in the world. If I can keep these same symptoms and get off Pred at the same time, even better. I'd even try a near-liquid diet for 1-2 weeks to see if I could heal the inflammation that way and work the diet back up to see if I can get into a mostly symptom-free state.

Thanks again :)
Posted 1/10/2011 9:03 PM (GMT 0)
For my last flare the problem was in terminal illium. So unlikely the Rowasa enama would hit up there, but we still tried, and I put a pillow under my ass/hips to get the liquid to travel up. Maybe a 2nd dr opinion, never heard of dr not wanting to rx Rowasa. Also, how about canasa?

At that time I started at 50mg Prednisone, took ~10 horrific days to kick in, and that day I upped to 60mg. Also put myself on a low residue diet. Think Bland. about the only thing that stayed inside me was white rice and quality sashimi. I ate it daily.

When I Read Sunflower Seeds I get a stomach pain. I hope you are grinding them?

good luck!!
Posted 1/11/2011 9:46 AM (GMT 0)
beachlife..it seems there are more than one would even fathom of butt docs that are butt med phobic. Maybe they had to have them done for themselves and freaked. Seems it's as common sensed as putting polysporin on a cut.

I don't get that Rowasa would be used to hit the terminal ileum..that's the end of the small intestine.

Why would one even think it would go there when oral 5ASA meds are being used?

I'm perplexed and back to banging my head on the keyboarewflaks;dfk. again..sigh.
I've actually noticed faint squares on my forhead now that seem to read "what do you expect??" I wouldn't guess rectal meds to work for that osmotically?? proposed not.

texasmax...a liquid diet won't heal your colon...if it did, we'd all be on it.

Looking forward to hear the outcome of the appointment.

q
Posted 1/11/2011 2:41 PM (GMT 0)
Got the Rowasa. Leaving town this afternoon until Friday for work, so the enemas will have to wait until I get back.

He's fine with the current med levels, so long as I'm not getting worse (and I'm not), but wants to start talking next step options in the next 4-6 weeks if I don't start to improve (he favors Remicade) but I'm going step it up on the Rowasa as well as try some different diet changes to see if and what I can pull off.

Beach- whole sunflower seeds are fine, unless I have too much! I've actually switched to the butter as far as sunflower seeds go; need to update my sig.
Posted 1/11/2011 3:03 PM (GMT 0)
He also ordered a stool sample to re-check for C Diff as well (I was clean back in ~October immediately before my c-scope and diagnosis).
Posted 1/11/2011 5:23 PM (GMT 0)
I am sort of in the same boat at you are. I have noticed some improvement with the steroids, but not as much as I expected. Unlike you though, I am having HORRIBLE side-effects with the steroids (and I am getting mine via enema). I am seeing my Dr. tomorrow and will let you know the upshot.
Posted 1/11/2011 6:27 PM (GMT 0)
Yay...keep us posted.

q
Posted 1/12/2011 12:14 AM (GMT 0)
Please do! I'm thankful every day I DON'T have any side effects (yet).

I asked if he thought the Pred was actually doing anything; he felt strongly it was and that I'd be much worse off if I wasn't on it. Who knows.
✚ New Topic ✚ Reply