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How bad is prednisone?

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Ulcerative Colitis
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Posted 8/17/2021 5:51 AM (GMT -5)
Hello. I’m taking 4 lialda tablets (mesalamine) plus night mesalamine enema and morning hydrocortisone Enema but this last enema is getting very hard to keep on. It’s painful to insert it. I believe my below is irritated or sore for all the stuff that I’m putting in. Sometimes I have to put 2 or 3 enemas because they don’t stay for more than 5 minutes. I emailed my doctor. She said she could give me oral prednisone. I read side effects and it sounds scary. How bad it really is? Does it damage the liver that bad? How much weight would I gain? Would I loose that weight after the treatment? What about the moon face? I’m scared. My symptoms are worse in the morning with D and some cramps. After noon it gets better.
I will also have to go under surgery for another condition and I will have to stop my turmeric and moringa supplements. Those two were helping me to ease symptoms. Should I jump to oral prednisone or continue trying the morning enema that I have been using for two months already? Help me pls
Posted 8/17/2021 7:12 AM (GMT -5)
Prednisone can be very helpful if your inflammation is out of control. If you can use it for only 2-3 months that would be the ideal, it is longer use where the really horrible side effects hit me. However everyone is different. I didn’t gain much weight aside from extra fluids on pred, but I get terrible steroid induced anxiety and rage (my poor kids!) and I cannot sleep when I take it.
You could start with a steroid enema and see if that helps enough. I find that I can retain them much better when flaring than mesalamine enemas and the steroid dose is much lower than prednisone.
Posted 8/17/2021 7:53 AM (GMT -5)
It depends on the person and application. In low dosages it's generally tolerated well - many doctors make the joke of it being a 'miracle drug' as it can treat a wide range of problems with few risks. When you take it in large dosages or for a long time, however, it can definitely be unpleasant and sometimes cause damage. I will say from personal experience that I don't regret taking it, though. The inflammation I had was deadly serious, and Prednisone reduced it almost immediately. If you're in good health (other than gut issue), I wouldn't worry too much.
Posted 8/17/2021 9:43 AM (GMT -5)
I’m one of the lucky ones that didn’t get horrible side effects. I’d lost so much weight that a weight gain was welcome and never got moon face. I did have trouble sleeping and some irritability but the relief from some of the worst symptoms made it well worth it, IMO. It’s the drug we love to hate!! But I mostly loved it because it made me feel so much better. Again it’s the long term usage that can cause problems
Posted 8/17/2021 11:25 AM (GMT -5)
I would try Uceris (budesonide) first because it is safer and less systemic. The main problem with prednisone is the long-term side effects. If you do take it, make sure you are getting enough calcium and vitamin D because it can decrease bone density. One course is not going to be a big deal, but if you end up needing it again and again or cannot taper off of it, that's where the main problems arise. Yes, you may gain a little weight, but you can lose it afterwards.
Posted 8/17/2021 8:04 PM (GMT -5)
AM enemas are always a bad idea; doesn't your prescribing doctor realize that? Probably you would do better using the steroid enema before bed; then if you retain those, you would likely have more normal bowel activity the next morning. If so, you could switch to a foam retention med in AMs (if you're in UK, Europe, Australia, or NZ, you have a choice of steroid or mesalamine foam; in N. America only steroid foam) Foam is easier to retain than the liquid enemas. Other than foam retention meds, there are steroid or mesalamine suppositories that also require physician Rx. Unless you have severe pancolitis or a stenosis condition in part of colon, you are better off avoiding Prednisone-- or at least start it no higher than 40 mg daily and taper down by the end of 1st week on that. Even with steady tapering in successive weeks one can get moonface by the 6th week on Pred. Plus the COVID-19 medical experts now say that 20 mg or higher daily doses of Pred can make one more susceptible to the pandemic even if previously vaccinated. / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)
Posted 8/18/2021 12:33 AM (GMT -5)
Thanks everyone. You guys eased up my anxiety.
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