First time on Prednisone

I was diagnosed with Ulcerative Proctitis back in June, put on Canasa suppositories and easily reached a good remission. But, in late November I started having symptoms again and I had a Flex Sig about 6 days ago. It showed my inflammation has spread a good bit, as far as he could see with the Flex Sig, actually. So, I was advised to stop taking my Canasa and start on 40mg/day Pred and that the tapering would start once I feel "normal". Today is day 5 on the pred, and while I do feel somewhat better there is still a lot of D, some cramping, back pain, little appetite and the past 2 nights I was woken numerous times with D and passing a good bit of blood, and this goes on until about 30 minutes after I wake up. Most of this seems to calm down during the afternoons and evenings. Called the doc yesterday and was advised to go on a mostly Full Liquid Diet for a couple of days to see if that helped calm things down.

He also said that I will no longer take suppositories because the inflammation has spread too much for them to be very effective and that once I'm going of the Pred I will start oral Mesalamine. Does any of this sound normal, right or wrong in your experiences??

Thanks for the quick reply Lemon!

My GI said I would start the Oral 5 Asa's after the pred started working, maybe while I was tapering I think. Honestly, I was in pain and a bit traumatized from the Flex Sig when we were talking about things! He also said that the enemas wouldn't really be useful to me because the inflammation goes too far up now. The report says that "moderate inflammation was found in the rectum beginning at the dentate and extending in a confluent manner to at least the splenic flexure". That wording led me to believe the inflammation went as far as he could see with that scope. There were also many biopsies taken. My guess is the liquid diet is just for bowel rest in an attempt to get the suddenly increased bleeding under control?? I have to call in tomorrow with an update and might ask a bit more about starting other meds or supplements.

I only spoke to his nurse, and she passed on to me that he suggested a bland, full liquid diet...I wasn't really given any definition. She said juices, broths, creamed soups, yogurt, cream of wheat...things like that. Little to no spices or fat. I've done liquid diets in the past for a different health problem, so kinda know what to do I think.

While I was in remission I ate whatever I wanted with no trouble at all, but am a very healthy eater in general. Whole grains, local fresh organic produce, things like that. Not to say I didn't splurge on less healthy stuff from time to time. I figured since I went into remission so easily with Canasa the first time, and wasn't having any issues at all, big diet changes weren't what I needed at the time. But, once my flare started I cut out most junk food, and roughage and stuck with things that were bland and easily digestible. My big concern right now is why the bleeding has gotten so much worse a few days into taking the Pred, eventhough I feel a little bit better. I'm sure I sound kinda clueless and lost!

It's really not true that the enemas won't help because the inflammation goes too far up. No, the enemas won't treat the entire inflamed area, but they WILL very effectively treat the area which they can reach. Also, the oral mesalamine meds aren't all that great at treating the distal colon and rectum because their action is mostly topical, not systemic. The rectal meds, however, do a fantastic job at treating that area.

There are numerous studies which show the advantage of using both oral and rectal meds over using oral meds alone.

Thank you all so much for the info! My doc can be hard to get ahold of, but they do have an online service....maybe I should send him an email asking if he would be willing to let me start on Oral 5ASA's and/or a form of enema right now? What exactly is Rowasa?? Is it similar to Canasa?

For what it's worth, we think this recent flare was triggered by a cold I recently had getting my immune system all active, and the fact that I took Advil while I had that cold (since I was never told not to!)

     My problem was proctitis too. Do you know what medicine the doctor intends to prescribe?  When first diagnosed, in 1998, my doctor prescribed Asacol (I believe 1600 mgm per day), Rowasa enemas and a tapering dose of prednisone.  It kept me in remission for two years but then I suffered a flare in 2000.  Since it was proctitis and never traveled further into the colon, my doctor switched my maintenance med from Asacol to Colazal.  I believe the Colazal treats the rectal area more efficiently  than the Asacol.  Long story short, with every flare I was always prescribed a course of prednisone.  In 2002, my doctor placed me on 6MP, with the prednisone taper, Colazal and rectal meds.  Proctitis is the most stubborn to treat.  After the failure of 6MP, Remicade and then Humira and becoming prednisone dependent, I decided to have surgery in 2010.  Not everyone has this downhill spiral and I hope you can attain remission on the meds your doctor prescribes.  Best of luck and health to you!

It has been week 3 and I still have lots of blood. As soon as I weaned down to 6 from 8 all symptons have started to come back.m GI is on holidays till after New Years!

Is the pred all your taking at this point? Were you able to get any enemas. If not, if you still have some of the supps I would use those until you get some enemas and oral meds. Are you taking the pred all at once or twice a day? Some people do better with twice a day keeping the symptoms at bay better. I did better all at once especially with the insomnia issue.