Asacol+Prednisone...How Long Until Relief?

[CapricaNick]

Hi Everyone-

My name is Nick, I'm 26, and I've just recently begun my journey with IBD. Around 3 months ago, I began experiencing diarrhea/urgency/abdominal pain each morning and sometimes an additional 1-2 times throughout the day. Given that I hadn't had GI problems in the past, I assumed that I had some sort of virus and let it go at that.

About 6 weeks ago, I was feeling particularly bad and ended up going to an Urgent Care because of the issue. The doctor performed a rectal exam and noticed significant blood so I went through a series of cultures to rule out an infection. When everything came back normal, I was referred to a GI specialist. On my first GI visit, the doctor went through my symptoms and said that most likely I still had a viral infection and I was started on Cipro and Flagyl; however, I got an urgent phone call the following day saying that my bloodwork had come back abnormal with an elevated Sed Rate, C-RP, and that I was severely anemic.

I had a colonoscopy and upper EGD at the beginning of November which showed inflammatory bowel disease (mild to moderate inflammation in the transverse colon, ascending colon, and cecum). Unfortunately, the doctor wasn't able to definitively state UC vs CD although the fact that the inflammation didn't occur in the rectum or descending colon makes me think CD is more likely(?). I was put on 4.8g of Asacol and a tapering dose of Prednisone starting at 40Mg and decreasing every 10 days for 7 weeks.

In addition to the medications, I had already begun some major diet changes in the week leading up to my colonoscopy including cutting out caffeine, alcohol, dairy, red meat, raw fruits/vegetables, etc. Now I'm at day 18 on the meds and still dealing with pretty much the exact same symptoms. I've lost more than 20lbs and I'm now down to 134 (I'm 5'11) so I'm really feeling concerned about the weight loss. I've somehow moved beyond the hunger phase and now I have really little interest in eating given that even eating "safe" foods tends to at best give me abdominal pressure and worst diarrhea.

Can anyone give me a sense as to how long it took for symptoms to improve once you started your meds? I have a follow-up appointment with my GI doc in a week and I'm trying to understand what the next steps might be (higher dose of Pred, 6-MP, etc) to get things under control. I appreciate any feedback, thanks for reading.

Nick

 

[Crohn's 35]

HI there and welcome to the forum. 40mg is the standard predisone treatment for most. Pentasa is very mild and may help. It usually only takes a few days of Prednisone to start working but everyone's treatment and disease differs from person to person. Avoid wheat also, causes bloat. Do you bleed? Is that the reason for anemia? Has your doctor mentioned Remicade or Humira? You may not be in mild to moderate stages, and they could help, but could be too soon, see what the doc says. Diahreah can be controlled with Cholestyramine Questran alot of people take it, to control it. Keep hydrated by drinking fluids preferrably water. Hope I was of some help.

 

[My Butt Hurts]

Hi Nick,
Welcome to the forum!
40 mg is pretty common for starting on prednisone. I'm surprised that you don't feel even a little relief yet using that.
If you are worried about not maintaining enough calories, you might want to drink some Ensure, Boost, carnation breakfast drink with soy milk, or even Slim-Fast just to get some extra nutrition in you.
Hope that asacol kicks in really soon for you.
MBH

 

[imisspopcorn]

Welcome to the forum Nick.
When I was initially diagnosed with Crohn's, I was on the the exact same drugs as you...I can't remember exactly how long it took to feel better, but it was less than 4 months. Most people see a big improvement with steroids right off the bat. It's not uncommon to have rebound inflammation once you begin to taper down....I hope you start to have some relief soon.Good luck.

 

[CCSO3191]

I'm winding down my stint with the Pred. now. I'm at 5 mg every other day. And I've been on the Asacol for years. I saw relief with the D shortly after starting the Pred. But now that I'm practically off it the D has returned in a big way. Matter of fact I have an appt with my GI in a few hours to discuss options which include Lomotil and Questran. Good luck and remember what works for some of us doesn't work for all of us. Keep looking if you don't find relief with your current regime - its trial and error.

 

[fenway1971]

Sorry I missed this post the other day. Your background story sounds just like mine when I was diagnosed 6 years ago.

Took about 4-5 weeks for Asacol to work for me. I later found out that I was allergic to it. Prednisone should help quickly (i.e., within a week or two). If symptoms return, you might want to consider 6mp / Imuran or the biologics. I went from pred to 6mp and am feeling tons better.

This disease is tough to figure out sometimes.

 

[Wiggles]

In my experience if steroids are working, you will know within a few days. A couple of times I have started on high doses and they have worked amazingly well within 48-72 hours (as well as the side effects kicking in in the same timeframe, unfortunately).

Be wary of people telling you what to eat. The evidence about particular foods is very unclear, and what works for one person won't necessarily work for another, in fact more accurately it probably won't work for another. I have tried a variety of things - wheat free, gluten free, alcohol free, low salicylate... turns out that in my case none of these were a solution.

 

[body failure]

prednisone

have you or anyone else you know that has crohns disease and that is on prednisone have trouble with erections? i am told from doctors that it does happen but i am weaning off of it now i am down to 1 and a half tabs a day and have trouble with erections on and off...i am also on asacol hd as well.

 

[Miss Underestimated]

Asacol gave me worse CD symptoms than I had before I started it. I agree, you have to find out what you can and cannot eat. I have to eat a low residue diet - no insoluble fiber, some foods with soluble fiber - I can eat broccoli and cauliflower, etc if I cook them til they're mush, but most vegetables make me very uncomfortable.

Have you told your doctor you aren't feeling any better - I think you should always report that right away. No need to suffer if you're actually reacting to the medicine - better to find out right away.