Emergency use of Prednisone or other med?

[Pebbledash]

Hi all,

As some of you might know, I have been doing well for 5 months on LDN + cholestyramine. Unfortunately, I have had more bad days over the last couple of weeks, and a couple of nights when I have (hate to say this) uncontrolled nocturnal Diarrhea.* Even in the bad old days, nocturnal D was pretty much unknown to me, so it is a far from pleasant surprise.

My question is this. I have unused Prednisone. I used some once for another condition, and within hours I was constipated--so it obviously works. Is it feasible to use Prednisone for a couple of days to see if it can "turn me around." Alternatively, I could use Budesonide in the same way--take 3 tabs for a few days (which I have been doing on occasions).

Is it problematic to use steroids in this way? Can they be used in an ad hoc way or does this cause future efficacy issues or other rebound issues with my inflammation?

Thanks in advance.

Cheers,
Paul
* I eat a high fiber diet so this may be in (large?) part to blame. I enjoy eating fresh fruit and veg--perhaps this has unsettled me (particularly watermelon?)

[tex]

Hi Paul,

As far as I'm aware, prednisone is always used as a tapered treatment, with a steadily decreasing dose over a period of a week or two, rather than just a couple of days. You might research this, and find different options, but I believe it's always prescribed as a treatment regimen using decreasing dosages. I'm not sure if a short treatment without the taper would cause adrenal issues, but it might. Adrenal issues are a potentially much bigger problem with prednisone, than with budesonide, since prednisone a so much more effective systemically.

Pred is almost surely the fastest, surest way to stop the D. If maintaining control after tapering is a problem, you might have to transition to budesonide as you taper off the prednisone. But don't take full doses of both concurrently, because the pharmacodynamics of the two drugs are additive. In other words, increase one, as you decrease the other, if you need to transition to budesonide. I assume you realize we're in uncharted waters, here.

I hope this helps,

Tex

[tex]

Paul,

I just now noticed your added comment about watermelon. Please note that virtually none of us can tolerate watermelon, even after we're in remission, because it apparently contains anti-nutrients that we simply can't handle. Therefore, I would recommend eliminating the watermelon, especially if that's a daily ritual, before resorting to medications. That said, the damage may have been done, and prednisone might be needed to shock your immune system back into a normal pattern of performance. After eliminating the watermelon, and most of the fiber (since you're already in a flare), if the flare doesn't resolve (or at least improve) in a day or so, you might have to resort to a medication.

Tex

[Pebbledash]

Hi Tex,

As so often is the case, I am indebted to you. My consultant is great, but there is so much lore on this board that even specialists don't know about MC.

It's tough. I want to eat healthy foods, but frequently these are foods that are naturally high in fiber. The difficult thing about MC is that it is--for me at least--a managed condition, so when there are bad periods it's not always obvious whether it is a case of just eating too much of the wrong thing or the emergence of an actual flare up. I hope this is a blip and that the LDN treatment continues to prosper for me.

Watermelon--I wondered about this, whether because I had previously read about it or whether it was just a feeling, but of all the fruits it definitely feels like it is a culprit.

I'll monitor my food and fiber intake and see what happens.

Thanks again, and take care.

Sincerely,
Paul

[Gabes-Apg]

Paul
I get that you want to eat healthy! albeit, for MC'ers we have to adjust our thinking/beliefs on what is healthy

I have had fairly stable remission for quite a few years and can not do a mouthful of watermelon with out major reaction
I can have small serve, once every 3-4 weeks of a higher fibre item. if I have large serve or have it too often my body reacts.

[Pebbledash]

Thanks, Gabe. As much as I am tempted, I'll keep watermelon at bay!

I do seem to be turning a corner, thankfully.

Cheers,

Paul