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Not responding to prednisone

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Ulcerative Colitis
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Posted 1/31/2016 4:06 PM (GMT 0)
Hi guys I was just wondering if anybody has been in this situation,

I'm 28 weeks pregnant and have been having a flare up since Christmas Eve, I've been on 30mg of prednisone since xmas eve and nothing seems to be changing, I rarely actually poo when I go to the bathroom it's just blood, I'm not feeling bad in myself it's just the blood bothering me, and I'm getting a bit worried as to what's going to happen from now, any ideas or similar experiences?
Posted 1/31/2016 4:47 PM (GMT 0)
Have you been tested for C diff?

I have seen a lot of people not respond to prednisone. I always had great luck with the evil drug but it's very individual. I know it's hard when you're pregnant... Have you seen your GI to ask about other options? I think the first thing, make sure you don't have c diff or another pathogen - get a stool test.
Posted 1/31/2016 4:50 PM (GMT 0)
I've been on prednisone before for two other flare ups and have responded well and quite quickly but this time just seem to want to happen aha, what's a c diff sorry? I only found out I have colitis nearly 3 years ago and haven't had much trouble so I've never really thought much of anything
Posted 1/31/2016 5:37 PM (GMT 0)
I am the same at the moment. On 30mg of pred and still bleeding and mucus. Everything else is pretty normal though. Waiting to hear back from ibd clinic as to way forward.
Do you take other meds as well?
The ibd clinic keep saying don't worry too much about some blood but it's all the time now so something needs to be done. I am going to try get some enemas
Posted 1/31/2016 6:20 PM (GMT 0)
What meds are you on?
Posted 1/31/2016 6:51 PM (GMT 0)
I'm on 75mg azathioprine, 30mg prednisone, calcium tabs
Posted 1/31/2016 8:08 PM (GMT 0)
I was on 40 mg of prednisolone which seemed to work but as soon as I came off them I flared up again. My doctor put me on 30 mg of prednisolone this time and they are not working. This flare up is worse too, im going toilet 6 times a day and its mostly blood, like you, urgency is an issue too. Hope you get sorted soon.
Posted 1/31/2016 8:57 PM (GMT 0)
C diff or Clostridium difficile is a bacterial infection in the large intestine that causes inflammation, diarrhea and essentially mirrors what a ulcerative colitis flare appears like. For that reason, it's essential to get a stool test to rule out pathogenic causes when we demonstrate flare symptoms. C diff responds to antibiotics. We happen to be more prone to c diff than the normal person on the street.

Regarding the prednisone, some are steroid-refactory (meaning it simply doesn't work for you). It's very rare but possible. The more plausible answer is the prednisone dosage of 30mgs might not be enough to conquer your flareup. You might need 40mgs or more. IV steroids are also possible, but requires admission to the hospital for monitoring.
Posted 1/31/2016 9:05 PM (GMT 0)
I was steroid refractory. The only way I would respond to it was at 60mg. Usually that was done in the hospital via IV. I would go home with the oral dose at 60 mg but as soon as I dropped below 60 my symptoms would come rushing back. You may need a higher dose. This may be one of those trial and error things. Hope you get it sorted out soon.
Posted 1/31/2016 9:08 PM (GMT 0)
I wouldn't mind but they have told me to stay on this dose for 8 weeks now in a row even though I've made phone call after phone call explaining how it's carrying on
Posted 1/31/2016 9:12 PM (GMT 0)

Gorga said...
I wouldn't mind but they have told me to stay on this dose for 8 weeks now in a row even though I've made phone call after phone call explaining how it's carrying on

Time to start raising some hell then. You shouldn't be ignored. Sorry you're dealing with this.
Posted 1/31/2016 9:14 PM (GMT 0)
Thank you! I know I feel like I should be looked at and sorted properly rather than a 10 minute phone call or 10 minute appointment for my babies sake
Posted 1/31/2016 9:21 PM (GMT 0)
there has been good adivce here:

1) check for c-diff - pred does not work on it
2) ask about 40mg or 60mg pred for a few weeks, and then taper
3) consider rectal meds

I would add:
1) add a mesalamine, unless you have had a prior bad reaction
2) get test to see if azathioprine is being metabolized correctly
Posted 2/1/2016 12:24 PM (GMT 0)
My issues are similar. I have made another 2 calls to the ibd team today asking to supplement with rectal meds as I am tapering and they have said no!!
I can't believe it. Am I missing something? I am considering just going back to my normal gp but I know they will refer me back to the ibd team. What's the point in continuing with something which doesn't work?!!
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