Not too sure what dose but not max I know that for sure. I've tried aza and had an allergic reaction, I was told I needed either surgery or another medication at the start of the year but it don't want to go down the, ,surgery route yet and the other med have serious side effects that I can't afford to risk at the moment. Yeah really really not happy with my treatment! Thanks for replying
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As others have said, the long term use of corticosteroids for Crohn's such as pred has been abandoned for decades due to the problems associated with steroids and the availability of more effective and less damaging drugs such as azathioprine/6mp or biologics such as remicade/humira/cimzia etc.
If you cannot tolerate azathioprine, did you try 6mp (which is the pure form, azathioprine is an analog that is converted to 6mp in the body)?
The "surgery route" to treatment is a bit misleading, surgery is indicated for Crohn's patients to remove scared tissue/strictures or blockages, it is not a long term treatment form, but is used to rectify problems with certain affected bowel parts that can't be treated any more in other ways (resection, stricturplasty of strictures, which are narrowings or removal of blockages).
The usual way of getting to manage Crohn's through drugs (mind you, equally important is diet, stress relief, managing vitamin and mineral deficiencies, potentially sport etc.) is to go for biologics like remicade or humira if immunosuppressives such as aza fail.
As said above, while you took a rather low dosage of pred, it still can have many side effects if you use it as long as you have, for instance the thinning out of tissue. Compared to the effects of pred, biologics long-term (if you tolerate them initially) are much rarer. For most people, biologics do not have any serious side effects, even if taken long term (just to counter your point that you cannot afford serious side effects at the moment).
Lastly, one more thing on surgery, it is of course paramount to check out the activity of your Crohn's and any potential damage in your colon and small intestine through a colonoscopy, an MRI and an endoscopy if you currently have trouble and haven't had those diagnostic procedures in a while. If you got big ongoing problems, you might also have strictures in your intestine which, if severe, should be dealt with.
All the best to you. As to immediate changes, of course you can increase your pred dosage for now to 10mg (after all after 4 years a few more weeks doesn't matter any more) but as others have said, it is important to find a new, a good GI and discuss a new treatment plan that works for you and is generally accepted as a responsible long term treatment of Crohn's by the medical community.
