Is Prednisone the right choice

[AmberLee]

Hi there, my name is Amber, and I’m a 30 year old female diagnosed with Crohns about five years ago after a major flare and colonoscopy.

Since being diagnosed, I’ve had three more major flares. The first one was treated with Prednisone and Asacol, and cleared up in about three months. The second flare, although the doctor prescribed the Prednisone and Asacol again, I decided not to take the meds, as it didn’t seem worth it to me, seeing that they took three months to work the previous time. It cleared up on its own after a couple of months.

Now I am currently sick for the third time since I’ve been diagnosed. This is the first time I’ve had a flare in over a year. I finally went to see the doctor today, as it has been three weeks now with severe pain, ~15 BMs/ day, and no sleep at night. The doctor wants to put me on 30Mg Prednisone for at least 6 weeks. I am extremely concerned about this. As of next Tuesday, I am being promoted to a high stress, high responsibility management-level position at work. I am also getting married in a few months, the first week of July. I’m really struggling with what to do. I do not want to start taking the meds, and then have to worry about withdraw if I decide to stop them. Right now I feel like I have somewhat control of my life, even with the pain and frequent bathroom trips. I’ve learned to work around it with limiting my diet, and restricting what times and how much I eat (i.e. not eating anything several hours before bed, eating small snacks throughout the day at work). I’m afraid what the Prednisone will do to my body and mind if I start taking it. I was wondering if anyone else has ever contemplated this dilemma, and how it turned out? My main worry with not taking the meds, is that my symptoms are pretty bad now, and I don’t know how I would be able to tell if I’m truly in a dangerous situation where I should get myself to the doctor. What risks am I taking by trying to control this on my own and let my body heal myself?

Apologies if what I am asking is naïve, or has already been answered on the boards; I’m still very confused about this condition, and my doctors have been very vague with answers. This forum is a great resource, and I will definitely be spending a lot of time on here

 

[Terriernut]

AmberLee, you've got alot of stress on your plate right now, and that isnt going to help your Crohns one little bit.

You can try the SCD diet. But, I have to say, letting inflammation go out of control is going to cause scar tissue, and that you dont want. How about asking the Dr for Entocourt instead of pred to get the inflammation under control. And then perhaps some other maintenance drugs?

 

[AmberLee]

Thanks for the response, Terriernut. I'm not familiar with all the meds, because I've only had four major flares, and the only thing I've ever been given is the Asacol and Pred. I will talk to my dr about alternatives. Maybe I am worrying unnecessarily, but six weeks of Pred is a daunting prospect for me. So I guess you answered my "what's the worst that can happen" question. I assume you are saying each time this happens and the longer it goes untreated, the scar tissue damage can make further complications worse? Again, I apologize but I am at the point where I am burying my head in the sand and probably not as informed about these things as I should be. I need to change my attitude, but right now I feel like I'm teetering on the edge between complete denial and that very dark sad place

 

[tiloah]

Prednisone is a great drug for treating acute inflammation, but if you don't treat what's causing the inflammation, I think it will come right back. In other words, you need to be on a form of treatment (usually a maintenance medication) that works for you and is doing its job. Prednisone is not a good drug for long term treatment. The other side of that is maintenance meds are great at preventing flares, but not great at getting them under control. You need to take or do *something* to get your flare under control so that your maintenance regimen can do its job. Whether or not that's Prednisone is up to you and your doctor, but I can say it is a good drug and has helped a lot of people.

I hope you find a treatment plan that works for you and you are comfortable with. Sometimes us Crohnies are faced with choices we don't want to have to make, but letting this disease do its thing is never a great option. Good luck.

 

[Susan2]

Prednisone has a bad rap, but I was diagnosed with Crohns back in the early 1970s when there was a much smaller choice of drugs. The sulfasalazines (salazopyrin) made me very ill and metronidazole (Flagyl) and azathioprine (Imuran) had no effect on my symptoms. Prednisolone was the only drug that gave me any relief and I was on it for 25 years in varying dosages (between 60 and 5mg) which, after a few years, I managed myself.

I am not saying that it is the ideal drug to be on, but it has a definite place in the Crohns medicine cabinet and you don't need to be frightened of using it when necessary.

 

[jimmyf]

Personally, I have had no issues using Pred, in fact it has helped immensely to keep the inflammation down during bad periods, but as has been mentioned, it cannot be used long term, other drugs such as mesalazine do that job. Everyone is different and considering how many others have used the drug, I would not be too worried about its use, you will just need to use it and see what happens. I tried Pentasa in the past which didn't agree with me so I changed.