Can you take prednisone if you have an abscess?

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KWalker

KWalker

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Short and sweet, can you take prednisone if you have an abscess? I couldn't find anything concrete online that is one side or the other. Some say it can potentially cause the infection to spread, others say it can really help the crohns, which in return helps the abscess.

Any suggestions/experience?

Thanks
 
I was put on pred at the same time as having an infection but was also loaded with antibiotics. xx
 
I have multiple fistulas and when I was on pred my doc told me if I developed a new one or if they didn't drain to come in right away.
 
Thanks guys, you pretty much said exactly what I've found online as well, that there are different views/opinions on this.

I'm on Cipro and Flagyl again (only for a week for some stupid reason) but I was also given a prescription for Prednisone (40/7, 20/7, 10/7, 5/7) and I've actually considered taking it to see if it helps my crohns so I can possibly prevent more abscesses but I don't want to take it if it's going to make things worse. I'm not sure what to do.

And if I do have to wait until it's not active anymore, how will I know?
 
Hi Kay - I had an obstruction last year that perforated and caused an abscess. Was in the hospital for 9 days,on pred and antibiotics. They couldn't get a drain in the abscess, and didn't want to do surgery. Sent me home on pred and 16 days of antibiotics, but didn't stop the pred. A month later, CT scan showed the abscess was growing again, and I had to have surgery. The surgeon was upset that they had taken me off antibiotics instead of prednisone, and said that he didn't understand why anyone would think the abscess would resolve in that scenario! He said that once the inflammation had gone, I should have been taken off pred and left on antibiotics, and then there would have been a chance the abscess would have healed.
 
How come you have had to go back on them again? (If I've missed a post somewhere point me in the right direction).
I would be hesitant of taking them. Can you talk to your doctor and check again before you take them?
 
If you want a med to prevent abscesses maybe a immunomodulator or biologic is a better bet as opposed to pred. Pred seems to put you at risk for abscesses but even if it could help, you can't be on pred indefinitely nor would you want to.
 
Are you talking to me Holly? I've been having quite a bit of problems with my new abscess again so I'm on Cipro and Flagyl. A GP gave me a prescription for Prednisone too in case I wanted to take it, but I haven't yet. I'm draining quite a bit right now but the doctor only gave me a one week prescription for the Cipro/Flagyl so I need to go back and get more so I can hopefully get it to continually get smaller.

NGNG- I currently don't have a GI so I can't get anything else. I'm waiting on a referral because our medical system is run by morons. Apparently I need a new referral to see a doctor again because it's been "too long" since I've seen him. Like crohns just clears up or something...
 
I was on Pred. with an abscess, but I was on the Pred. (30mg) before the abscess appeared, so not taking them wasn't an option. They just threw a ton of anti-biotics at me and treated it at that. And it did go down, but it was touchy for awhile. 2 weeks of IV anti-bitocs and a week of oral at home.
 
When I had my abscess the first time they put me on pred. But thats because as I came in through A&E they treated it as a flare of crohn's. They then realised I only had an abscess so they tapered me really quickly.
 
Hmm, well that's what I was thinking... If the prednisone could help the crohns, wouldn't it in return help the abscess? Abscesses happen because of crohns problems, so to me, it would seem like it would work, but if I'm only taking Cipro and Flagyl I'm only really treating the small problem, rather than the problem causing the problem.. if that makes sense
 
It does make sense...
But could it be something to do with the abscess being an infection and pred suppressing the immune system?
Like when I wanted to start infliximab and they wouldnt let me. I hope infliximab will help the crohn's and I wont get more abscesses but I couldn't start it until I had no abscesses.
 
You would think... But this disease is like an evil mind master. Just like biologics can treat or cause psoriasis or arthritis, pred may well be able to prevent or cause abscesses. It's just not worth the risk in my opinion since the side effects are overwhelming and it's only a bridge drug.
 
Hey KW,

Yes you can take Pred with an abscess because you have to think of Pred being used not only for an inflammatory disease but unfortunately one that is often associated with infection due to its location. Inflammation and infection go hand in hand with IBD and treatment means they need to co exist in order to bring flares and complications under control.

It will be difficult to treat an abscess with antibiotics if it isn't drained first...Since antibiotics are blood borne and an abscess is an enclosed sac it will be difficult for the antibiotics to penetrate that sac. Has it been drained?

Matt was on Prednisone when he had his psoas abscess. It was drained (he had a drain in for three months) and the antibiotics helped resolve the abscess. The Pred kept his inflammation in check and I feel helped stabilise the whole situation.

Dusty. xxx
 
I don't have time to reply fully right now because I'm on my way to work but Matt didn't have problems being on prednisone while having an abscess DustyKat?
 
Okay, I have some more time now because I'm on the bus. The abscess IS draining (without surgery) because it fills up, drains, fills up, drains. After dealing with abscesses for as long as I have, I know enough to know that the moment I stop the antibiotics, it's going to come back unless my crohns gets under control. Which would seem right now it's not.

I'm not exaggerating when I say the abscess is quite large, so at this point the way I look at it, it can't get much worse. Right now I look at it like I could continue what I'm doing with the antibiotics (which the prescription is up in half a week already) and I could potentially need surgery OR I could take the prednisone, know that it could potentially make things worse and cause me to need surgery BUT it could help my crohns and therefore stop the abscess. Either way I could face surgery but with prednisone I'm thinking I do have the potential to make it better. That's what I'm thinking.

Would it be better if I got another prescription for the Cipro/Flagyl so I was on them while on prednisone? I could probably do that
 
I would think you would want the Cipro/Flagyl combo to work on the abscess while the pred was working on the active CD. I hope things calm down for you, kwalker.
 
Matt didn't have any additional problems with the combination KW.

By the sounds of things you need further treatment with antibiotics and combining with the Pred is probably the way to go.

Good luck!

Dusty. xxx
 
Steroids are great for acute inflammation, but will slow healing process overall. Always get conflicting statements from GI vs. surgeon. Best to get off of them with abscess ASAP.
 
Hey k, sorry you're not doing well ATm, how's your diet been recently? I found as soon as I consistently started eatin bad id get pretty bad stomach cramps, so I'm hoping I'm not currently flaring. Anyway hope you feel better soon
 
Kwalker I thought of you because I had a doctor today (albeit not a Crohn's doctor) but well respected one tell me I might need Entocort to fight my perirectal abscess. It goes counter to what I read about steroids possibly contributing to or making it more difficult to heal an abscess. Maybe that only applies to prednisone and not Entocort which doesn't release throughout the body. Anyways it reminded of this thread.
 
I've always been given really high doses of hydrocortisone IV along with antibiotics when I have abominable abscesses. Unless the crohn's inflammation is controlled the abscess will keep returning. I presume its the same for your situation. I'm hoping you are feeling better now K but just wanted to add my tuppence worth. You've been battling this abscess with cipro and flagyl for quite a while with no success so I'd think it would be worth giving the pred a go to see if it resolves the situation once and for all. How is it all going?

edit: that should read abdominal abscess although they usually are abominable. Must have been a freudian slip. :)
 
Last edited:
The GI docs push the steroids to halt the flare, but the surgeons who have to actually fix the problems are anti steroids.Constantly in the middle of this tug of war with my daughters's perianal disease.
 
I don't know about Pred, but I was put on Entocort when I was first diagnosed, and had an abscess and a fistula at the time.
 

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