Why do I have to stop taking Prednisone?

[Kenswood]

Hi I have been on Prednisone for 2 weeks now started with dose of 15 tabs a day and reducing I am on my last day now. It helped me tremendously as I had got to 39 kg in weight. Would like to know must I stop and for how long before going on again as scared to lose what I gained even the side effects worth it.
Also do I have to worry about kidneys and liver handling this long term. I don't take Crohn's medication as have found them to make me depressive. I take Ultra flora as cannot obtain combo forte anymore. Plus have had surgery for hiatus Hernia which went badly as my vagal nerve was accidently cut which has caused me to be a bit like a locust what goes in comes straight out. Sorry don't know all the medical terms can anyone advise pse.

 

[UnXmas]

Hi, what do you mean by not taking Crohn's medication? Prednisone is one of the medications used to treat Crohn's.

Some people do stay on prednisone if it's the best option available, but generally doctors will avoid it as the longer you stay on it, the more risks you are exposed to, some of which can be irreversible. In particular, it can reduce your bone density (making you more prone to breaking bones), affect how your adrenal gland works, affect your blood sugar and cause eye problems like glaucoma and cataracts. Not that everyone on it long-term will get these, but there's always a possibility. I'm not sure about the risk to your kidneys or liver.

Have your doctors talked to you about alternatives, and do they plan to have you take something else now that you're coming off prednisone? Whether prednisone is the best treatment for you or whether there are alternatives is really something your doctor should know, as it varies from one person to another, but usually prednisone is used short term to get the Crohn's under control, and then a safer treatment is used long-term, if needed.

Has prednisone helped you gain weight because it got your disease under control or because it increased you appetite (or both?)? An increase in appetite is a common side effect of prednisone, but if you can keep eating enough once you're off it, you shouldn't lose the weight again, as long as you're absorbing your food properly.

 

[Inwe]

Prednisone is a temporary fix. You need a drug that better targets your disease. Are you seeing a GI (gastroenterologist)? or just your GP (family doctor)? If you are just seeing your GP I HIGHLY RECOMMEND asking for a referral to a GI specialist.

Weight is a small part of the overall problem. When I was really sick once, I lost 50 pounds in a matter of months and started taking prednisone. However, prenisone doesn't "treat" crohn's. It's a stop gap to help maintain symptoms (and gain weight). Like UnXmas mentioned above. Long term prednisone can cause a lot of problems, some irreversible. There are so many side effects that it's hard to list them all.

Here's a list of them and other facts you need to know about steroids:
http://www.mayoclinic.org/steroids/art-20045692?pg=2
http://en.wikipedia.org/wiki/Prednisone#Side-effects
http://www.drugs.com/sfx/prednisone-side-effects.html

And if you're feeling anxious or depressed your doctor can prescribe antidepressants. Either long term ones or take-as-you-need (like Ativan)

 

[Orchid]

Prednisone is a corticosteroid with a complex web of side effects. It mimics a hormone called cortisol that your body produces in response to stress whose role is largely to increase the amount of energy the body has to deal with emergencies. It raises your metabolic rate, triggers blood sugar production, slows bone repair processes, collagen production and the reason it's used as medication - it downregulates many processes vital to the immune system. The body also becomes dependent on prednisone instead of cortisol and stops producing the chemical itself, which can leading to Addison's Crisis (a situation which requires immediate medical attention) if you go cold turkey, in addition it can cause: can cause diabetes, blindness (as a double jeopardy side effect with the aforementioned one), osteoporosis, massive joint necrosis, severe skin complications, slow wound healing, and muscle destruction.

Note: these are all long term use side effects, you would need to take the drug for quite a while to see most of these.

 

[Kenswood]

Thank you I have not seen a Gastroenterologist for a while now about 5 years ago last.
I have been seeing a G.P. I have moved from one Town to another these past 5 years and Everytime I have had to find a new Doctor. I will ask for a referral as suggested just hate the thought as first thing they want is a colonoscopy which is extremely painful Everytime.
To be honest I have been trying to look after myself as I am tired of all the invasive procedures. I am 56 years old and have had this problem starting when I was in my late 20's. I realize though that I do need someone like a good Gastroenterologist controlling my meds so will take this advise. Thank you to all replies.
Regards
Heidi

 

[UnXmas]

I know it's difficult, Kenswood. If you do need another colonoscopy, can you ask for more sedation? I had an endoscopy recently, and was given the choice between a throat spray or sedation. I went with the latter, and remember nothing at all about the procedure. I woke up later on the hospital ward, feeling fine. I had a colonoscopy many years ago (I don't have a colon anymore, so haven't had a colonoscopy in a long while!) and experienced the same - no memory of the procedure.

There are some medications much safer than prednisone that can be used long-term. Prednisone can have great results, but long-term its risks can outweigh its benefits. If you're currently seeing a GP, try asking them about other medications you could use if your symptoms come back once you're off prednisone, as well as asking for a referral to a gastroenterologist.

 

[Kenswood]

Thank you so much for your encouragement I will do so I was actually heavily sedated with the last one I had but screamed the theatre down apparently I upset everyone there that day including patients waiting to go in. I have been off prednisone 2days now and already having bad dumps with cramps crawling with pain right now. I have taken codeine phosphate and buscupan to alleviate this, think I will have to see a Doctor on Monday as cannot carry on like this. I would like to ask you do or did you have extreme back pain as well my lower back seems
In a lot of pain. My Crohn's is in the ileum is this consistent with the pain I experience. I really appreciate you talking to me as I have no one besides the Doctor to talk to and haven't really found one that I am happy with yet. Also because I can no longer work am going to have to resort to Government Hospitals now as can no longer afford a private Doctor.
Regards Heidi

 

[UnXmas]

Hi, back pain isn't something I've experienced either from Crohn's or prednisone, so it might be that your pain is unrelated. I hope you're able to find a good doctor!

 

[Kenswood]

Thank you I will be out looking for one on Monday. I have put myself back on ciplox antibiotic and probiotic as stabbing pain in bowel and heavy mucus with loose stools very smelly at the moment. Thank you so much will update you after seen a Doctor.
Regards
Heidi