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Would you ask for prednisone tablets?

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Ulcerative Colitis
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Posted 3/28/2017 9:32 AM (GMT 0)
Hi everyone,

I have extensive colitis and I have been flaring since last June. I have at all times continued with asacol tablets maximum dose and first tried prednisone steroid foam for about 6 weeks which worked but after a traumatic event I re-flared and was put on uceris for 16 weeks. I was advised by the consultant to stop taking the steroid tablets about three weeks ago at a time when I was still having symptoms- about 6 BMs with urgency, some bleeding and mucus and exhaustion. Just before I stopped my frequency increased to 9 BMs a day. I had nothing left to help and so I have been using salofalk enemas day and night and this has reduced symptoms to around 7 BMs a day with bleeding on around 1 BM and my bowel feels slightly stronger. My BMs are formed apart from the first couple of visits which are watery possibly from the enema or me or both. I can hold on to the enema (could not do so when taking uceris) but it is distracting and wakes me up on and off all night. The consultant thought the symptoms would fade away but I think without the enemas I would be really ill now. When would you ask for prednisone tablets? Should I give the enemas another 3 or 4 weeks? Or do you think prednisone would have a similar outcome to uceris? I feel like the steroids only masked symptoms and now I am starting the recovery process with the salofalk enemas but perhaps a stronger steroid would be different. Thanks
Posted 3/28/2017 1:27 PM (GMT 0)
my advice would be to continue with the enemas for another 2 weeks (as long as you continue to see some improvement) - if things are well, then maybe start tapering a bit - you'll have to determine that -

if things don't improve, then maybe a round of pred (no more than 30 days)till you figure out what's next -

hang in there -
Posted 3/28/2017 1:45 PM (GMT 0)
Rectal steroids and uceris are most effective for mild inflammation. If you're in the 7-10 a day range then prednisone is a better match. As prednisone is for severe inflammation which your symptoms match.
Posted 3/28/2017 2:30 PM (GMT 0)
Just chiming in, but the Cortifoam was a huge help to me - and my inflammation is mild in the sigmoid colon area and worse in the rectum. It took the Cortifoam about 5-6 days to fully work but since then it's been a Godsend. Still having some symptoms (a little bleeding) on Cortifoam and 25 mg prednisone while waiting to start Remicade, but: urgency, tenesmus, frequency and pain are all gone and I have both energy and appetite back.

I'll also add that I've tried enemas before and had a terrible time retaining them. I was VERY inflamed when I started the Cortifoam - I was coming off a mesalamine intolerance reaction and my symptoms were the worst they've ever been when I started the Cortifoam. It was easy to use and retain even under those circumstances. I do lay on my left side for 30 mins to try to help it "reach" a bit further and that seems to help.
Posted 3/30/2017 4:34 PM (GMT 0)
Thanks for your advice everyone. Soynomore, I am curious why you suggest a 30 day course of prednisone? I thought it had to be about 12 weeks….just so I can comment to my consultant…30 days sounds a lot better if it can be a treatment plan smile

I flared again soon after using prenisolone steroid enemas last summer. Is cortifoam the same drug?
Posted 3/30/2017 10:55 PM (GMT 0)
Cortifoam is a steroid like prednisone. Although cortifoam is hydrocortisone a slightly different steroid than prednisone.
Posted 4/2/2017 6:25 PM (GMT 0)
Thank you everyone, so glad that enemas exist! I still feel embarrassed collecting them but it's worth it!
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