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Prednisone, Low sodium diet and fruits

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Ulcerative Colitis
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Posted 9/24/2016 1:19 PM (GMT 0)
Hi everyone.

For those of you who didn't see my other thread, I am in a severe flare and about to start taking 40mg Prednisone for the first time. I really want to do everything I can to curb the moon face and weight gain, so I'm planning on limiting my sodium as much as possible.

Can someone tell me what low sodium foods are good with UC? I know fruit is generally a no-go because of the fiber content, but will it be okay since I'll be on the prednisone?

Thanks in advance!
Posted 9/24/2016 2:48 PM (GMT 0)
I never got the moon face unless I was on prednisone for more than 10 days. While you will retain fluids on prednisone it's not really a long term problem since the excess fluid will go away when you taper off the drug. A lot of the weight gain from prednisone, at least in my case, was because I was hungry ALL THE TIME. :) So you have to really watch what you eat, especially between meals. That weight gain is more of a problem because you've actually added body fat due to the caloric imbalance.

Try the pred for a few days before you get too concerned about the side effects. They may be minimal in your case, and 40mg isn't an over the top, huge dose.

You should really see some big improvement in symptoms in 2-3 days and possibly sooner. If you haven't found it already, there's a lot of good info here:

http://ccfa.org/

Also, do talk to your doc about something like Humira if you can get your insurance to cover it. The biologics are really becoming front line therapy for UC.

Good luck. I felt so badly for you when I read your first post about your dx and flare. Let us know how you're doing once the pred kicks in.
Posted 9/24/2016 3:46 PM (GMT 0)
I will, thanks Richard! Knowing how well this drug works for most people, I am unbelievably excited to hopefully achieve some level of normalcy here shortly. I can't wait to function again, omg.

I don't know how long I'll be at that dose. After I convinced my doc to start the Pred he wants to see me in a week, so I anticipate we'll talk about the length of time then.

How long are most people on higher doses with symptoms like mine? Tough question, I know it varies from person to person, but are we talking weeks? Months?
Posted 9/24/2016 3:50 PM (GMT 0)
What I don't want to do is taper it too really. I don't have an enormous amount of confidence in this doc right now, so I'm a little concerned that once my symptoms get better, he'll want to taper too early. I don't know what 'too early' is, but he seemed to think that the 3mg Entocort would resolve my flare on two weeks....
Posted 9/24/2016 5:31 PM (GMT 0)
Prednisone is a synthetic version of an anti inflammatory chemical that your body makes normally. That's why it works so well and also why the long term side effects are so bad. Your body is used to it at very low levels, but not at the levels you use to treat a UC flare. One issue is that your body stops making it at normal levels for a long time after you've taken the synthetic version.

I've never been on 40mg for more than a few days before starting to taper. Did your doc give you any instructions to taper, or is it just 40mg per day until further notice?

By the way, pred gives me terrible insomnia. If that happens to you too, ask if you can take the whole dose first thing in the morning. My doc was fine with that. Once I get below 20mg per day the insomnia stopped being a big deal.

You generally want to get off pred ASAP. Like a week or two.
Posted 9/24/2016 6:40 PM (GMT 0)
Oh that's a lot faster than I expected! I was anticipating a month-ish. I sure hope it works that fast for me, I just don't see how it's possible to go from such a severe flare to remission in a week. I'd be ecstatic if that happened.

Right now Doc hasn't said a length of time. He's prescribed me 40mg for six days and to see him on Friday.
Posted 9/24/2016 7:43 PM (GMT 0)
You should really be much better in three days. It's a "break glass in case of emergency" medication, not something that can be used to maintain remission. The tricky part is not flaring again when you come off the prednisone.

Maybe my GI is overly cautious but he really doesn't like to have me on it for more than a week including the taper and no more often than once a year. If you're in substantial remission by Friday, which is certainly possible, I'd expect him to start your taper then.

I'm just really annoyed as hell at him now that he didn't put me on Humira two or three years ago.
Posted 9/24/2016 8:17 PM (GMT 0)
I mentioned in your other post that I had gained weight on Pred, but I agree that Pred causes you to feel insanely hungry all the time, and I seem to have a craving for sweet stuff to boot!, I do believe that is the Pred, as normally I never crave sweet stuff, so I think if you just make sure you don't eat the wrong foods and exercise you may be okay, not everyone gains weight, we all differ. I also think that the longer you are on it is when the weight gain and other problems arise, as I was fine for a month and then after that is when I started to notice the changes. I have a swimming pool, and so I have started using it! which I should have been doing long before...
Posted 9/25/2016 1:00 AM (GMT 0)
I'm not sure about the others, but I have never been on it for just 1 week. It doesn't even really suppress your adrenal system until you are on for longer than that. My doctor always starts me at 60 mg so my taper takes longer, but generally I taper down every 10 days. So usually 60 mg for 2 weeks, then 40 mg for 10 days, then 30 mg for 10 days, then 20 mg for 10 days, then a much slower taper (15mg, 10 mg, 5 mg, 2.5 mg, 2.5 mg every other day, done). All and all the taper takes me 3+ months depending on if I stabilize at those intervals. 3 months may seem long to some, but his taper schedule has always worked for me where I never had to go back up to a higher dosage.

The way to not be hungry is keep drinking water all day long. It will fill you and keep your salt level down. Also, stay away from packaged food and restaurant food since they both always contain lots of sodium. I was always too sick when on pred to eat anything but really bland food anyway. Lots of plain grilled chicken, plain fish, baked potatoes, white rice, bread, peanut butter.
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