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Is Prednisone worth it? Should I start it?

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Ulcerative Colitis
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Posted 9/4/2007 5:29 PM (GMT 0)

I have mild UC, but after an 8 month remission, I have had a horrible flare with no letting up for the last 3 to 4 months.  I am on 9 Colazal now and my cort enemas stopped working after helping on and off for the last year.  My GI gave me an antibiotic to see if it helps and another pill that helps with bowl spasms, but none of this has worked.  I do not know what to do, and he has been hesitant to put me on Prednisone for the year and a half I have seen him, but wrote me a prescription to fill if the current meds don’t work.

 

I read all of these awful posts, but I am tired of the current flare that has lasted so long.  Is it worth going on the steroid? ! I can’t suffer like I am, but I hear such awful things about Prednisone.  I only have mild-UC, as my scope last month reconfirmed.

 

IS it worth it?  Will I experience awful side-effects?

 

Thanks

bluechipguy

Posted 9/4/2007 5:41 PM (GMT 0)
My current GI believes immunosuppresants are preferable to steroids and that steroids should only be used as a last resort. Since your case is mild, it's possible you could be put on a relatively low dose and tapered off quickly... but you never know how you might react.

Have you tried manipulating your diet and/or going on a liquid diet to give your bowels a chance to rest? Some folks have found an elemental diet to be an alternative to steroids.
Posted 9/4/2007 5:49 PM (GMT 0)

I have not tried altering my diet in anyway.  MY GI never mentions diet during treatment.  I do not want to start the steriod if I do not have to, but my quality of life is suffering anyway.

My wife wants me to try accupuncture first, although that may take a while to help, if it does at all.

bluechipguy

Posted 9/5/2007 4:00 AM (GMT 0)
Just my 2 cents worth....

I am new to this sight and I have a post close to the top about the same thing....Starting Pred.

I was quite leary about starting Pred. because of all the scary stuff I was reading, but as you know the quality of life just plain ol sucks. So after talking with my dietition, naturalpath and another doctor, they all recommended I take a medium dose for 2 weeks and see how that goes. I have been on it now for 4 days and so far Ive been a little tired, maybe a little irritable (i think from being sick and tired) a little heart burn and thats it so far. So far, I do believe I am starting to see something happening, the urgencies and blood have slowed and I have times were I actually feel good. So I believe things are working the way they should.

Just remember "OPINIONS ARE LIKE BUTT HOLES....EVERYBODY HAS ONE" (thats suppose to be funny, not bashing anyone :) but you also have to remember that everyone is different and will react differently to a medication. You have the last say of what goes into your body and how long you are willing to take it. I personally would tell you GI that you will try it for no more than 2 weeks and then get off. Thats what Im doing.

Now regarding Pro Biotics......I was just talking with my dietition this morning and she has come up with 2 Pro Biotics that have been tested for the affectivness for UC and these 2 have proven to help prolong remission in UC suffurers........VSL #3 ( 1 - 2pak / day) and FLORASTOR ( 2 / day) Now I know nothing about these exept what I just told you now because I just learned about these this morning. So if anyone has any more information about these please share.

I also talked with my dietition regarding going with my naturalpath for more help and she recommended sticking with the doctors approach and diet until we get a handle on it, then let the naturalpath help out with the food sensitivities and other stuff to help stay in remission. That was just her opinion.

I hope this helps, It can get a little scary when you start getting flooded with all these different stories.

Take care.
Posted 9/5/2007 1:08 PM (GMT 0)
I am dealing with 50mg of pred daily, started at 40, went up to 60 because I couldn't get the flare under control. I absolutely hate the darn drug. It's been about 7 weeks and yes it is one of the things that helped but you have to pay the price. I am getting off ASAP. If you can avoid it, do. Just my 2c.
Posted 9/5/2007 1:50 PM (GMT 0)
I've been on pred for a better part of this year. the longest i've been on is 3 years. Pred is evil but it can do a lot of good. Some people don't get the side effects that a lot of us seem to get. The evil part to me is not just the side effects but that some people become steroid dependent and there is no way of telling if you are one of those people before you start. For me pred does a great job in the beginning. I feel great withing a few weeks of starting. But as I taper things get worse and I have to be bumped back up. I am one of those who also gets horrible side effects, though this time around they are different than last time.

Have you considered a steroid foam or enema? There are less side effects involved there....but i suppose it depends on how involved your colon is.


Whether pred is worth it is up to you. It can really help, if you can stand the side effects. I started back on it this time because my quality of life was so bad that I was williing to do anything. But we had a plan in place for if I couldn't get off of them. Prednisone allowed me to walk across the stage for my graduation and attend two out of town weddings. This made it worth it to me. Although I will say that after this i am never going on it again. I am hoping the Imuran will work for me if not on to remicade. I am done with steroids.
Posted 9/5/2007 1:59 PM (GMT 0)
Keep in mind, too, there are also differences depending on your dosage and the amount of time you're on the stuff. If you're started at a high dose, you'll have to be on it longer and have a longer taper... and you're alot more likely to experience the unwanted side effects. Another thing to keep in mind is if you're already at risk for osteoporosis, (read: you're a small-boned, white female) the bone thinning effects can be more devastating than if you're not already as risk.

bluechipguy said...

I have not tried altering my diet in any way.  MY GI never mentions diet during treatment. 

If you're serious about wanting to avoid/reduce meds, you need to investigate dietary changes. Most doctors will not mention it to you and, if asked, they'll say diet doesn't make any difference. Yet there are MANY people out there who know from their own experience it DOES make a huge difference and there are plenty of IBD books that discuss different dietary therapies. A few I'd recommend you check out:

Listen to Your Gut by Jini Patel Thompson

http://www.crohnsalternative.com/

The New Eating Right for a Bad Gut by James Scala

http://www.amazon.com/New-Eating-Right-Bad-Gut/dp/0452279763/ref=pd_bbs_sr_1/002-6060902-1888064?ie=UTF8&s=books&qid=1189001083&sr=8-1

Breaking the Vicious Cycle: Intestinal Health Through Diet by Elaine Gottschall

http://www.amazon.com/Breaking-Vicious-Cycle-Intestinal-Through/dp/0969276818/ref=pd_sim_b_3/002-6060902-1888064?ie=UTF8&qid=1189001141&sr=1-1

Posted 9/5/2007 2:11 PM (GMT 0)
In my humble opinion prednisone is a very effective albiet nasty drug.  My GI waited too long to put me on it and it didn't do a darn thing, so all I got were the side effects.  But I've heard from many people since, particularly those that have mild to moderate disease that a short course is all they needed to nip it in the bud and they were then able to stay in remission with the anti-inflammatories (e.g., 5-ASA).  I was like you early on and wanted to avoid prednisone at all costs, but in the long run I think that was a mistake.  If it had been used appropriately it may have helped to stabilize me.  The other options (i.e., immunosuppressants) are not without risk as well, so in the end it is all about weighing the pros and cons.  If your quality of life now is suffering you need to do something.

Louise

Posted 9/5/2007 3:38 PM (GMT 0)

Thanks everyone for all the replies.  I am not sure what the dosage my GI wrote me was for (it is in my medicine cabinet in case I need to fill it) but I am sure it is a low dosage.  It sounds to me like everyone is different based on dosage and side effects.  I know my father was on and off steroids for his cancer when he was alive and it did make him very hyper and irritable.

 

My wife has wanted me to try acupuncture and I told her I would try that before going on steroids so I guess I owe it to myself to try something easy like that (although who knows what that will do).  Maybe since I have mild UC (although flaring for 4 months with everyday symptoms doesn’t seem “mild” to me) makes me think maybe a low dosage will help without the side effects.

 

Thanks again for the advice

Bluechipguy

Posted 9/6/2007 3:48 AM (GMT 0)
I had a horrible reaction to Colazol -- is this a realatively new drug for you or have you been on it a while? I have moderate colitis too, although throughout my entire colon. I am on entocort, which is a steroid, but breaks down in the colon and does not have all the bad side effects of Pred (at least not for me -- no irritability, hyperness, moon face, weight gain). Also, Pepto Bismal 2-3 times a day will help with the diarrhea and it is perfectly safe to take even on a long term basis. Good luck!
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