Can Pred aggrevate gastroduodenal crohns?

[willpwuk]

Morning.

Well after the hell i've gone through over the past couple of months....It doesn't seem to have even come close to ending lol. To make things easier for those reading I have Crohn's both in my stomach/duodenum and Ileum.

Anyway i had surgery for my ileal crohn's but i was still put on a combination of pred and Humira afterwords to maintain full remission. I believe that's worked as i've had no pain or anything in my right side....however 5 days ago i started having ridiculous epigastric pain that hasn't gone away, along with that i've been vomiting (not large amounts but small) a couple of hours or so after eating and this continues throughout the day (I could have sworn i saw some of my dinner from way over a day ago but i digress.) It's definitely not an obstruction because i've been having constant diarrhoea since. Fat malabsorption diarrhoea actually.

Went to an out of hours gp (Who honestly really F****** impressed me. He really knew his stuff.) and he explained that it seems like the pred i've been taking has aggravated the crohn's in my stomach. Which is a bit confusing because the last time i had my GD crohn's treated i was put on a high dose omeprazole and pred???

(Side note he also mentioned that for the moment i should dilute my pred in water to reduce the risk of an ulcer burning through, anyone ever done this before?)

Honestly...I thought I knew a lot about Crohn's but still 4 years later i end up being surprised. Lol.

 

[ronroush7]

I feel like I am still learning. I have never heard of prednisone aggravating Crohn's disease.

 

[CallieS]

My prednisone prescription bottle says to take it with food or milk. At first I was taking it with a small bottle of Ensure/Boost type of drink. After a few weeks, I had severe heartburn. Severe. My whole upper abdomen and chest was on fire. Then I started taking the pred with a lot of crackers and a full glass of milk. And at the same time I was tapering the dosage. My heartburn went away. Was it the food and milk or tapering?

Fast forward, I'm on 5mg of pred daily. I figured that it's a low dose, so I started taking the pill with a small amount of food and no milk. A few weeks later, the severe heartburn came back. Now I'm back on food and milk. The heartburn is slowly subsiding.

Based on my very unscientific experiment, I believe that the prednisone contributed to my burning pain. My Crohn's is located at my terminal ileum, but several years ago I was diagnosed with gastritis, so I have stomach problems anyway, but don't normally suffer from severe heartburn like I did with the pred.

 

[Jabee]

Prednisone has irritated (a really inadequate word) my duodenal crohn’s as well. I was prescribed sucralfate to help and it really did. I think I was taking 40 mg of prednisone when this happened but the dose may be lower. Are you still taking a high dose of a PPI? I take 60 mg of dexlansoprazole (dexilant) twice a day even though I’m not on prednisone at the moment.

 

[willpwuk]

Prednisone has irritated (a really inadequate word) my duodenal crohn’s as well. I was prescribed sucralfate to help and it really did. I think I was taking 40 mg of prednisone when this happened but the dose may be lower. Are you still taking a high dose of a PPI? I take 60 mg of dexlansoprazole (dexilant) twice a day even though I’m not on prednisone at the moment.

I swear to God the irony of this is annoying me lol. Take something to treat something but then have it irritate something else. I'll ask my G.I about that thanks! However i was told today that omeprazole and renitadine (spelling?) usually aren't given together (which i know isn't true because i've had combination therapy with them before.) Yeah i'm on 40mg atm as well.
Yes, i'm currently on 80mg (40mg twice a day.) on top of the pred.

 

[Jabee]

I couldn’t believe it when an ER doctor told me that. I’d been hospitalized for a bad flare and was back in the ER because my abdominal pain got worse. That’s when I was told prednisone could actually cause abdominal pain as well. I used to take no medication. Now I take three different things for crohn’s (dexilant, linzess, and entocort) and two more to deal with the anxiety and depression that come with it (Celexa and Wellbutrin). That’s not including the anti-nausea meds, pain meds, and acute migraine meds. My 95 year old Mom takes nothing!

 

[Glockola]

This is what steroid cream can do to skin. Imagine it can give stomach ulcers.

 

[willpwuk]

I couldn’t believe it when an ER doctor told me that. I’d been hospitalized for a bad flare and was back in the ER because my abdominal pain got worse. That’s when I was told prednisone could actually cause abdominal pain as well. I used to take no medication. Now I take three different things for crohn’s (dexilant, linzess, and entocort) and two more to deal with the anxiety and depression that come with it (Celexa and Wellbutrin). That’s not including the anti-nausea meds, pain meds, and acute migraine meds. My 95 year old Mom takes nothing!

Welp. Yeah same thing just happened to me except i've got ulcers fml.You're so right about the meds. My dad takes medication for his heart and even his comes nowhere close to what i'm taking. It's ridiculous. To think before my crohn's started i never took any meds or even visit the doctor but anyway...i Digress. I'm on pred (currently), Humira, Cyclazine, Omeprazole, ranitadine, meds for vitamin deficiencies (via injections), and medication for tacchycardia. Sometimes it makes me realise why i end up feeling like crap with everything i'm taking.

 

[Glockola]

I am glad I found another member suffering from tachycardia. Currently on propranolol for that ****. Do you know why you have it?

 

[Guerrero]

Prednisone gave me stomach issues too!
Some of my doctors ignored it, and forgot to gave me PPI with prednisone... result was i ended up with nausea and sickness... it took months to get better ...

 

[willpwuk]

Glockola honestly no one can figure out why. Some think it's related to Crohn's and some aren't sure. I briefly heard the A&E doctor mention about my blood acids not being great Something about my Lactate being too high and something else being only 50% (which is why i assume they gave me 2 bags of fluids.) So i'm not 100% sure. I wish i paid more attention because sometimes it feels like they don't tell you everything.

 

[willpwuk]

Guerrero. Sigh. You'd think it was common knowledge to prescribe PPI's with pred. I don't know how you managed tbh. I took pred a couple of times (literally) without ppi's and i paid for it.

Thanks for all the info everyone!
I've been told that they're going to keep a close eye on me and give my stomach extra strength protection because i need to continue tapering however i'm at risk of an ulcer burning through. Lol. -_-.

 

[Glockola]

hmm, interesting. High lactate will give tachycardia so that could be it. Thiamin deficiency causes high lactate. That could probably be related to the Crohn's. Anemia would also give increased heart rate, so would thyroid disease.
I wonder if I have the same thing?

Im also on an PPI for stomach issues since two weeks, lol.

 

[Glockola]

willpwuk I think I solved the issue, Loss of bicarbonate stores through diarrhea leads to a metabolic acidosis state characterized by increased plasma chloride concentration and decreased plasma bicarbonate concentration.

That would explain why they gave you bags of fluid. And also your blood acids. Tachycardia is a symptom.

 

[willpwuk]

Thanks for that information Glockola. I actually discussed this with my GP and they said it may be in fact related to B12. I had my b12 checked and while it wasn't too bad (350 pg/ml) My GP said anything less than 400 pg/ml especially with someone that has absorption issues, could be considered deficient especially if symptomatic.

She mentioned that b12 deficiency can cause acidity in the blood to raise therefor leading to Tacchy among other symptoms so she's having me do a special blood test called MMA.

Honestly i ******* love this forum at times. There's research i'd never would have considered doing and questions i never thought to had asked my doctor if it wasn't for everyone on here. I'm sure doctors get pissed off at us a majority of the time because i have been told so many times that i'm quite 'medically aware' lmao.

 

[Glockola]

My b12 came back at 240pg/ml but my MMA and Homocystein all completely normal. I do not think B12 deficiency causes acidosis.
B12 deficiency usually causes anemia and neuropathy. Anemia would also be a cause of tachycardia.
I would ask your GP to test you for vitamin B1/thiamine deficiency. Thiamine deficiency causes tachycardia and acidosis.