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Prednisone/Entocort

Does anyone know if there’s any benefit to alternating between Prednisone and Entocort (Budesonide) when needed for Crohn’s to potentially help with dependency/resistance?
 

crohnsinct

Well-known member
You don’t generally build up a resistance or a dependency with steroids. O was steroid dependent but that’s just her disease. Then steroids didn’t work for awhile and again just a matter of a ridiculously serious flare. We kept giving her the steroids along with other therapy changes and it eventually calmed down a bit.

A GI might make the decision to switch to budesonide or exclusive enteral nutrition if a kid has been on prednisone too much and they want to avoid the steroid effects on the whole body but in general most kids are tapered as soon as possible. One of my daughters cycles on and off EEN whenever her inflammatory markers start creeping up.

Once you have had steroids for way too long there is also another drug they could use called tacrolimus but they really don’t like to use that.
 
Oh okay this makes sense. I didn’t understand the dependency thing some talked about so now I get it.
I wonder if it makes sense to connect with a dietician who specializes in IBD to see if she can help put something together that focuses on an anti-inflammatory diet. Or since my son is lactose intolerant, maybe she could help us focus on eliminating most lactose in his diet. Right now, we need to find something somewhat easy that he could stick with.
 

crohnsinct

Well-known member
Registered dieticians are worth their weight in gold! Try to find one in a pediatric GI clinic. If your son won’t do EEN maybe explore the CDED. it is a diet and the first phase is 50% formula and then a restricted diet. After 6 weeks and improved markers you move to a much less restricted diet. There are lots of studies on it and endoscopic results are pretty good.
 
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