Proctitis flare with fever / steroids question

Hi all,

First time poster, really looking for some wisdom as I'm new to all of this. I'm 26 year old woman, was diagnosed with Proctitis in Feb of this year. Have done 2 monthlong rounds of Canasa and 1 of Lialda over the past 5 months, which have always helped alleviate the symptoms but my Proctitis comes back every time within 2 weeks - it wasn't lasting.

My GI gave me a prescription for Cortenema in case i needed it, so when my most recent flare up started about 2 weeks ago, I resigned myself to trying it (I'm wary of steroids in general, but knew canasa hadn't been working). I dawdled hoping it would clear up but then it got bad, more urgent symptoms/blood etc, on the 18th and so I started the cortenema. From that point it just got worse - symptoms didn't improve, I was bleeding a lot more, and in the last few days particularly, starting to feel unwell. This came to a crux yesterday, I was feeling terrible at work, running to the bathroom in pain every hour and by end of the night had a fever and chills. I decided not to take the enema and opted to go back to a Canasa in hopes it would at least help, but was up all night with fever and constant need to go to the bathroom.

My Dr can't see me until Monday but he did get on the phone and recommend a course of antibiotics and prednisone starting today to "stamp it out," since clearly nothing else is helping contain my proctitis, and then we could see how I'm doing on Monday. I took off work today because I didn't sleep last night and am still headache-y this morning, though the fever's gone down. I mentioned I'm scared/wary of steroids (my mom has bad Crohn's and has had several very bad experiences with Prednisone). Is this my only course of option now to deal with the fever and stop this flare? The idea of taking more steroids when the cortenema steroid seems to have exacerbated the problem is also worrisome, but I feel terrible and everything just seems to be getting worse, not better.

Any thoughts welcome!

Hi John,

Yes, it's chronic proctitis.

Up until this point I've only been on Canasa / Lialda. My GI said when I was diagnosed that it was mild/moderately active chronic proctitis and I shouldn't expect to flare up that often, maybe once a year (obviously that hasn't proven to be true). The antibiotics are because this specific flare up seems to be much more intense than previous, so he thinks there's a possibility an infection is adding/exacerbating it.

Thanks. I just picked up the prescriptions and it's a round Ciprofloxacin and then Prednisone (20mg 2x a day). I read through both drugs' instructions and it seems to say that they interact badly together - has anyone taken these? The list of side effects is daunting and I'm wondering if it's worth it or if I should stick with canasa and let whatever caused the fever run its course. I am going out of town this weekend and am worried I will feel worse with the side effects.