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Steroid resistant or symptoms related to something else?

Hi all,

I have had symptoms for the past 10 years, which solely involved abdominal cramps central above my belly button. In 2011 I had a bowel resection for a perforation, which was wrongly diagnosed as a burst appendix. I then had no treatment after this and remained well until May last year I started getting cramps again. I got referred back to my GI and had a colonoscopy that showed ulcers and inflammation at my terminal ileum. My GI also commented that my small bowel "looked withered" on my colonoscopy and I was diagnosed with Crohn's disease. I had a fecal calproctin test, which was 65. I also had a CT scan, where I swallowed the contrast which was "entirely normal, noting a healthy bowel join where I had my resection".

So I was on entocort 9mg for 7 weeks and felt no benefit. I went back to my GI and stopped the entocort and the next day started prednisolone 40mg. I have been on this for 5 days and still NO BENEFIT. What is going on? Last night I got bowel spasms again for about an hour for the first time since before starting any treatment. From reading this forum, this is an indicator of bowel obstruction? I have never ever been to hospital over these cramps.

I am so confused am I resistant to the steroids? I have used hydrocortisone cream before for skin issues and it worked very well so surely prednisolone should work too? I am supposed to taper down on Wednesday! I am confused obviously at the colonoscopy I had visible active inflammation, is it possible the steroids just aren't getting rid of this? Or have they got rid of it, and I continue to have symptoms (bowel spasms and pain on the LRQ) as a result of scar tissue/adhesions from my surgery in 2011? Why was my CT scan normal?

Pred works great for most people in a flare but doesn't for tothers. My son fell into this category. He started at 40 mg and never recieved any benefit only the nasty side effects. That being said it can take longer than 5 days for it to be effective and sometimes the taper needs to be slowed, meaning the GI changed the taper so you remain on the 40 mg a bit longer or make the taper steps shorter.

You could call the GI nurse and let her know that you haven't recieved any benefit yet at 40mg. The GI may such a bit longer at the 40mg before stepping down.

my little penguin

Staff member
Also inflammation might be going down but the nerves that send pain signals take time to heal after being inflamed for so long .
I know with Ds his inflammation was decreasing but the nerves took a week or two to "catch up " and not send pain signals