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Budesonide to Prednisolone back to Budesonide....


I was at my GI appointment yesterday and he has confused me, doesnt take a lot if I am honest but even still I am confused and wondered if any of you out there could explain his logic.

So I was diagnosed in February with Crohns in my ileum. Originally I was put on Budesonide to combat the inflammation. Back in June I then started Prednisolone along with Azathioprine (40mg of Pred and 100mg of aza). Gradually tapered the pred to 10mg per day and upped the aza to 150mg. Things were improving to some degree but they seem to have hit a brick wall at the moment. So yesterday when I saw my GI he has put be back onto the Budesonide at 6mg per day for a month then go down to 3mg for a month, still taking the aza at 150mg a day. I see him just before I go down to 3mg.

Can anyone help with why I am swapped back? What might my GI be thinking etc etc?

I am also only allowed to eat a low residue diet. This disease sucks as I love food!

Many thanks.

F x



Yeah, I've done that too!
I've got it in TI too, and started on Budesonide and Aza many years ago.
Last year my inflammation went haywire and caused a blockage, hence the Pred for nearly a year. Then back on Budesonide. And I stayed on this for 3 months.
My understanding is, Budesonide is non systemic, it goes to the small bowel and TI and not the whole system, whereas Pred does the Full Monty!
So maybe the inflammation needed the Pred to get it under control and the Budesonide to maintain.
As for the low res diet, yeah it's boring! But it does give the bowels a little rest. Keep a food journal then slowly introduce other foods back into your diet. Not a good idea to stay on low residue for the long term, IMO. You'll need some fibre adding eventually to kick start the natural peristalsis.
Good luck
Joan xxx
Hi Joan,

Ah that all rings a bell now about the Budesonide. Thank you for refreshing my memory. I get so nervous seeing my GI that I forget to ask vital questions. I am actually glad to be off the Pred, I have gained 17pounds in weight on that horrible drug.
I was switched originally as everytime they tried to wean me down off the Budesonide my pain would come back so by the sounds of things the Pred was used to "blast" the inflammation so heres hoping it has worked.
The azathioprine seems to be kicking in now too and luckily my blood tests have all come back good so I am obviously tolerating the drug!

Full blown remission here I come hopefully!

As for the diet, I think its only a temporary measure to rest the bowel as much as possible as like you say you couldnt sustain a low residue diet long term!

Many thanks again,

F xx


Yeah I piled it on too, but it soon fell off!
I'm in remission now and you'll get there too, these steroids are a small price to pay for feeling good again!