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When will the prednisone start working?

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Ulcerative Colitis
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Posted 1/28/2015 11:30 AM (GMT -5)
I have been on prednisone a few times - and I just started a 40mg taper a week ago. I am to take the 40mg for 10 days (until Saturday) and then start tapering down by 5mg every 7 days from there.

In the past I have gotten relief from prednisone but I can't quite remember when things started to get better. It seems this time it is taking much longer than usual as I am still experiencing diarrhea and pain when I go to the bathroom. Seems like the bleeding has stopped though. I am usually ok during the day but the night is the worst - any time I move in the bed I have to go to the bathroom. It's horrible and I just want it to end.

I do have a slight suspicion that I am allergic to the Pentasa that I am on and I am going to see my GI tomorrow to talk on that but could that be causing diarrhea? I never ever had a problem on Asacol so I am going to see about switching back to that - the only reason I was ever switched to Pentasa was because of the whole thing where they stopped making the smaller dosage of Asacol....thinking I am going to talk to them about taking the Asacol HD tomorrow as well as doing Rowasa enemas for a month and then tapering off of them and back to Canasa.

Any advice is much appreciated!
Posted 1/28/2015 11:57 AM (GMT -5)
Never could understand why if a patient was doing good on Asacol 400 that they didn't just switch them to the HD 800 or go on Delzicol, unless it had to do with an insurance issue. Yes, the Pentasa could be giving you diarrhea, although it does better for me than the Asacol did. You need to find better remission strategies so you don't have to go on pred several times. It often works less and less the more times you use it. You should have a remission strategy good enough to keep you in remission instead of waiting to get worse and then going on prednisone again.
Posted 1/28/2015 11:59 AM (GMT -5)
Prednisone can work quickly and that is mostly depending on you having the correct dosage, and depends on the amount of damage the flare has caused (healing takes time). Don't expect prednisone to work exactly the same as before, as every uc flare is different. You might need a higher dosage this time. You might need to be on prednisone longer this time to achieve the desired results. To that end, a taper schedule is just a recommendation, not a hard and fast, set in stone schedule. Stay in contact with your gastroenterologist throughout the process, look at results not the time initially given, and proceed based on your results.

It's possible your disease has progressed in extent and severity. That's what flares can do. So, you might need stronger maintenance medications for your uc going forward. Good luck,
Posted 1/28/2015 2:25 PM (GMT -5)
Sometimes when I am on a high dose of prednisone, my GI will tell me to stop my other meds. If you really think the pentasa is potentially causing more harm than good, it may not be a bad idea just to see if that's the case. For me, I haven't had any issue with being off mesalamine while on a high dose of prednisone. I think the amount of time pred takes to work depends on the flare up. i've had it work nearly overnight and I've had it take 10 days. Last time I was on 40, I don't think I ever got to perfect stools but later I had a lung issue and went on a higher dose which wiped out every bit of UC inflammation nearly overnight. You just have to give it some time. Not seeing blood is a big improvement. Switching back to Asacol sounds like it would be a good idea in your case.
Posted 1/28/2015 9:42 PM (GMT -5)
Prednisone usually works pretty quickly for me. Could be 40mg just isn't enough for you this time. In a really bad flare, the prednisone takes a couple days to kick in for me and then the pain comes back every morning until I take it and goes away in an hour or so.
Posted 1/29/2015 12:05 AM (GMT -5)
Before I started on remicade, prednisone was taking longer and longer to break my flare...2 weeks and beyond. In hind sight, I think I could have been managed better. I was only on max asacol. I think the rectal meds are a good idea. Rowasa was always helpful for me.
Posted 1/29/2015 12:14 AM (GMT -5)

iPoop said...
Prednisone can work quickly and that is mostly depending on you having the correct dosage, and depends on the amount of damage the flare has caused (healing takes time).

Try not inflamming your intestines. Prednisone allows me to see what foods are acceptable as I improve, setbacks are due to putting food I am sensitive into my GI or allergic. I start feeling like a new man and degrade into sweet treets and the effect wears off.

Then I get serious and redefine my diet as mostly protein which is hard given the hunger but I found all flared up no fruit no tomato sauce just

- boiled eggs
- chicken
- clean peanut butter
- Udi bread

works, just going to lunch with boss I can feel the food additives at a 'healthy' restaurant. Chili's burger with daughter on the go usually fine but all flared up - do not repeat burger is entered into food log.

Food log gets very specific very clean. Taper is easy with no inflammation.
Posted 1/29/2015 12:42 AM (GMT -5)
I think it can vary from individual to individual. From my experience, the first time it worked fairly well and took about a week of suffering before it kicked in. The second flare up I had it took a little longer. And I was lucky I found a doctor who knew what to do to and gave me a shot of Steriod type meds and started improving the following day.

I think that sometimes the pills are not strong enough. I recommend going back to doctor and asking for a shot. Of course this worked for me and I can suggest what I experienced. I wish you luck and just hang in there. I always say that if you don't feel something is working or you don't feel good go back to the doctor or do like I did and visit another one.

Best of Luck.
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