1 year flare up-looking for advice

[cornhuskernick]

Hello-

I'm 33 years old and I've had Crohn's since I was 7. I've been through various treatments over the years (steroids, Remicade, Rowasa) and a number of anti inflammatory pills. I've always kept a positive attitude and have lead a pretty routine life.

I've been on an off and on flare for approximately 16 months now. At times the flare has been very bad and at other times it's subsided to where it's almost cleared up or cleared up for a short period-BUT then it returns and I can't shake it entirely.

I'm currently taking asacol daily and Rowasa nightly. My doctor and I have discussed putting me on 40 mg of Prednisone-he and I have a good relationship and he gives me decision in the end (I suppose that's the case with everyone).

The last time I was on Prednisone it didn't work and I went on Remicade which worked wonderfully for a number of years. I had to go off Remicade after picking up an awful case of Histoplasmosis, so it is not an option today.

My question to you, if in the past Prednisone failed to clear up your flare, have you ever tried Prednisone again at a later date with success?

I'd love to hear your feedback, thank you in advance.

Nick

 

[24601]

Hi! Welcome to the forum!

I haven't been in the situation you described with pred having failed in the past and wondering whether to retry but perhaps someone else has.

I did wonder though if you've ever tried exclusive enteral nutrition to get into remission.

Are immunomodulators and biologics ruled out because of the histoplasmosis?

If so enteral nutrition sounds like it might be a valuable option for you

Best of luck. Do keep us updated.

 

[Lady Organic]

I believe if your GI suggests to try it again is because its possible for pred to work again even after a previous failure. however it seems you will need a maintenance treatment afterwards, because you dont want to continue going in limbo with disease like this, unless pred sets the path to better times, which is also possible. If all immuno-supressors puts you at risk for histoplasmosis again, a dietary approach such as 24601 suggests could be an interesting option.

 

[nitty]

What dose of Pred did you start on the first time? Maybe it wasn't high enough, or needed a bit longer on the higher dose before tapering.

When I had it I started on 40mg/day to taper by 5mg each week, but as soon as I dropped to 35mg my symptoms got worse again. I went back to 40mg for another 2 weeks then started the taper again and this was successful. Meanwhile I started Aza which was taking effect whilst I was on the Pred.

Perhaps a different steroid regime for you may be all that is needed?