Did prednisone heal my colon?

[Lawyerboy]

Hi all,

In March 2012 I had a colonoscopy and it turn out I had severe Crohns all over my rectum, large bowel (no skip areas) and 10 cm of inflammation at the terminal ileum segment of the small bowel. In addition, it turned out I developed two strictures; one in the transversing colon and one in the descending colon. My GI immediately put me on 80mg of Prednisone for a couple of weeks and 150 mg of Imuran (Imuran failed me in the past bigtime though). The Prednisone stopped the diarrhea and fevers and I gained my weight back, but all my other issues sustained, like abdominal bloating, abdominal noises and pain. I managed to taper the Prednisone to 30mg a day and still take the Imuran.

Today I had another colonoscopy performed and it turned out 85% of my gut-lining is completely healed! I only have inflammation left at the terminal ilieum in the length of 5cm and some inflammation in the descending colon. Moreover, according to my GI the two stricture completely disapeared. Obviously I am very happy about that because my GI already started to talk about removing my colon. However, I don't understand how is it possible my gut-lining healed? According to medical literature Predisone only suppresses inflammation but never actually heals it. Can someone shed some light on this? My GI was quite surprised too. Moreover, why do I still have issues like abdominal bloating and pain? Hope you all can share some insights with me

 

[David]

Some people achieve mucosal healing on steroids. For example, one study found that 92% of patients on steroids achieved CLINICAL remission within 7 weeks but only 29% had mucosal healing evident by endoscopy. Conversely, it may negatively affect mucosal healing as a study of patients on Remicade found that those who were on steroids at the same time had a LOWER incidence of mucosal healing than those just on the Remicade.

You mention that you were on 150mg of Imuran at the same time, do I understand that correctly? It has pretty good data when it comes to mucosal healing so that may be your benefactor.

 

[Lawyerboy]

Thank you David. I take Imuran indeed, but I failed Imuran already two times. I had a resection while being on Imuran for years and despite the Imuran the Crohn's reappeared after surgery.

 

[David]

Have they ever checked your metabolite levels, specifically 6-TGN while you were on Imuran to make sure it was in the therapeutic range?

 

[Lawyerboy]

They did recently; still waiting for the results.