No improvement on prednisone?

[mactrey]

I was diagnosed with "mild, mild Crohn's" in April after several months of bloody diarrhea and stomach aches. My other symptoms are pain in my lower right and lower left abdomen. Vegetables and dairy make my symptoms much worse. I have been taking only Lialda up until a week ago, with no real improvement, so I asked my GI doctor for a stronger drug.

I have been on 40mg of prednisone every day for the past week, and haven't seen much improvement. My doctor told me I could expect to see a near-complete remission of symptoms within days. Has anyone else experienced something like this, where they didn't quite respond to prednisone? It makes me wonder about my diagnosis - could it be some kind of intermediate colitis rather than classic Crohn's, if prednisone isn't helping? And if prednisone doesn't help, are there really any other options? It seems like steroids are the strongest, quickest-acting drug that we have for Crohn's right now.

Before I went in for an endoscopy and got diagnosed, I assumed that I had ulcerative colitis, and started smoking cigarettes again, and they seemed to help my symptoms almost immediately. I haven't smoked since I was diagnosed, and my symptoms have returned. If smoking seemed to help my symptoms, could that contraindicate Crohn's? Since I know smoking is supposed to make Crohn's worse - but worse in the short term, or only in the very long-term?

Thanks for any help you can provide! My doctor hasn't been very capable in answering these questions.

 

[Kev]

I started off at 60 mg of pred since last May... and no improvement at all. Yet, in hospital, I was on I/V pred... sumedrol (spelling) and it worked wonders.. Coming out of hospital I had to go back on oral dose of pred... and my symptoms worsened a lot, and fast. I don't know if there is a difference chemically between the 2 drugs, or if the delivery method makes a difference... but it sure made a difference in how I felt.

Now... if it is Ulcerative colitis you have... smoking appears to have an almost immediate benefit... (non smoking advocates hate this, but it is true).. There is a distinct possibility that your diagnosis could be wrong... it can be hard at time to distinguish CC from UC. If it were me.. and I found something that made me feel better, I'd go with it and care less what others think.

 

[wondering]

I too was diagnosed with "mild" Crohn's and ended up on prednisone when I got no response from Pentasa. The prednisone did nothing. I actually remember feeling really guilty like I must be doing something wrong if I wasn't feeling better because I knew that I was supposed to. I eventually ended up getting admitted, put on IV steroids (which also didn't help) and finally on Remicade after getting a CT which showed no improvement despite months of prednisone. So if you're not feeling better, tell your doctor, sometimes that prednisone doesn't seem to work the way they expect.

 

[David]

Hi there and welcome to the community.

Were you diagnosed with an endoscopy or a colonoscopy? And do you have active inflammation just in the colon or higher up in your intestinal tract as well?

In my opinion, there is no such thing as mild Crohn's disease. That's like saying you have a mild case of cancer instead of saying you have stage I cancer. Hopefully they can get that stage I cancer under control before it goes to stage II and worse, but either way, it is a SERIOUS disease just as Crohn's is. I feel doctors need to educate people as to the seriousness of Crohn's disease in a way that doesn't invoke fear, but instead empowers the patient to take their condition seriously and so that both patient and doctor do everything in their power to reach deep, stable remission. Far too often I see people here with, "mild" Crohn's disease who suddenly end up with a resection.

 

[xmdmom]

Regarding smoking, I would speak with your doctor if you think smoking helps-- might nicotine alone be helpful and less dangerous than cigarettes?