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Ulcerative Colitis
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Posted 1/17/2016 4:03 AM (GMT 0)
Hi all, I'm sure this is a very dumb question but I'm a little unclear on what I should do.

My PCP referred me to a GI for a colonoscopy because she suspects I have a form of IBD and am experiencing a flare. I have had concerns for a few years but have never had the financial stability (recent grad) to undergo testing but I have been experiencing pain like never before this time around. She wrote me a prescription for an antibiotic (proctitis) and also wrote me prednisone saying something to the tune of I should start it if the pain gets to be too much.

She had explained that during the colonoscopy they will take biopsies and look for ulcerations and inflammation to make a diagnosis. My frequent trips to the bathroom are very painful and I'm really considering starting the prednisone but am not sure if I should because I'm worried that it will make recognition and diagnosis during the colonoscopy difficult. I'm actually a nurse so I feel really dumb asking this but I was wondering if I should not reduce the inflammation so that they can make a clear diagnosis or if I should take the prednisone so that I can (hopefully) find some relief.

I know that this is not the place for medical advice, but I was wondering if anyone here had any experience with this sort of situation and if anyone was diagnosed while already being treated with steroids. Thanks for reading
Posted 1/17/2016 4:21 AM (GMT 0)
How much prednisone did she give you (dosage wise)? I agree- it would make a colonoscopy difficult because it could hide some of the inflammation of it is in there. Have you made an appointment with a gi doctor yet? It can take a while so I understand if you can't wait and want to start the prednisone.

I would not take any antibiotics without a stool sample confirming you have an infection. Not a good idea at all. Do you know what she gave you?
Posted 1/17/2016 4:31 AM (GMT 0)
I have not been in contact yet, but was told that people that are referred and considered in a flare are seen usually within a week or two at max(though MLK may change that).

The prednisone is 20mg, two pills once a day with breakfast.
I'm taking Cipro 500mg twice a day.

I had lab work done but no stool sample but I have a visible cavity of puss that is draining around the entrance of my anus, she also said that she encountered pus during the rectal exam which is why she gave me the antibiotic.
Posted 1/17/2016 4:43 AM (GMT 0)
Did she think it was a fistula?? If so, that is typically a Crohn's disease symptom. I've never had one so I can't give you any tips on that one! I'm guessing she packed it for you so you have to keep the area clean.

That's a low dose of prednisone so it probably won't do much for you at all of you do have IBD and are in a flare.

The cirpo can make IBD worse so just watch out for your symptoms going bonkers. Make sure to take probiotics daily while you are on it.

Let us know when you get in to see a gi. There is not much we can help you with if you don't have a diagnosis yet.
Posted 1/17/2016 4:47 AM (GMT 0)
She actually didn't tell me what it was specifically, just said that it was not an abscess :/ thank you for your help! I will pick up some probiotics tomorrow and appreciate your replies.
Posted 1/17/2016 4:56 AM (GMT 0)
there can be pus with IBD, but also with infection like c-diff.

the biopsies will look for signs of chronic inflammation. Pred could reduce visual recognition, but it cannot change histology so quickly.
Posted 1/17/2016 5:02 AM (GMT 0)
thank you for the info, I appreciate it!
Posted 1/17/2016 10:20 AM (GMT 0)
A diagnosis for IBD involves negative stool test results (meaning, you don't have a pathogenic cause like cdiff), a colonoscopy, and biopsies. The colonoscopy is visual, where does the inflammation start?, is it continuous or patchy?, and what does it look like?. Cycles of repeated inflammation and healing in chronic IBD patients, irreversibly changes the appearance of our biopsies. The biopsies look for changes in the blood vessel pattern and in the cellular structure.

If you're an IBD suffer then your biopsies will prove it, even if the prednisone knocks out all inflammation.
Posted 1/17/2016 2:39 PM (GMT 0)
Cipro is a real heavy hitter when it comes to antibiotics. Are you tolerating it? But if there is pus, I understand why she had to prescribe it. Sorry about that.

btw, don't take the probiotic at the same time as the antibiotic.

Good luck with your biopsies.
Posted 1/17/2016 3:45 PM (GMT 0)
Prednisone may knock down the symptoms very quickly, but it still takes time for the colon to heal at the cellular level. Microscopic exam will still show signs of chronic inflammation, and visual exam may show scarring from previous flares. If you need the Pred, go ahead and take it. We all know it can have some nasty long-term affects, but so can UC flares.

(Also a nurse, and a 15-year UC survivor)
Posted 1/19/2016 1:00 AM (GMT 0)
Sorry for the late reply, I went to bed and had to work today! I think I'm tolerating the Cipro because I am having the same frequency and urgency as before and it hasn't gotten worse. I got a call from the GI place and they can't see me until March 4th and it will only be for a consultation which is very different from what I was told at my PCP office :/ I went ahead and took the prednisone today with that news and hopefully it will help some. I am getting married late April and cannot take off from work anymore and need the money.

I really appreciate everyone who took the time to reply, thanks!
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