Benefits of Entocort / budesonide?

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Jonas
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Benefits of Entocort / budesonide?

Post by Jonas »

What is the benefit of Entocort / budesonide if you have active microskopisk colitis but no bad diarrhea or stomach pain?
Is it only good for stopping D or are there other benefits as you see it?
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nerdhume
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Post by nerdhume »

Jonas,
There are many other symptoms of MC. Personally if I had no symptoms then I wouldn't take any medication. I also wouldn't take a steroid with all the side effects if I could control my symptoms with OTC meds (Zantec, Imodium, Tums, etc).
Theresa

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in remission since June 1, 2014

We must all suffer one of two things: the pain of discipline or the pain of regret. ~Jim Rohn
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tex
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Post by tex »

Hi Jonas,

I agree with Theresa. The problem with taking Entocort (or any corticosteroid) is that if you do not have diarrhea as a symptom, it will typically cause constipation, and that will cause cramps and abdominal pain (in addition to other problems).

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Jonas »

if I had no symptoms then I wouldn't take any medication
I have many symptoms but not often D.
My symptoms are weight loss, very tired, loud-talking stomach, pain in the hip joint (arthritis like symptoms), I have back pain, I have sore hands, feet, neck, like a slight inflammation. Feels a bit like I have a flu with fever, I'm tired with soreness in many parts of the body.

That is why I am asking about Entocort, could it help with any of those symtoms.

It says somewhere in the book that 60-70% achieving remission but diet changes alone. But that additional 25-35% achieving remission with both Entocort and diet changes. With remission means when all the symptoms the disease can cause or is it mainly that it no longer has any diarrhea?

Can Entocort reset food sensitivitys? (Because the mask sensitivities in tests)

Do you think that LDN a better first choice if you do not have diarrhea as the main symptom?
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Post by Gabes-Apg »

Jonas,
Entocort can help reduce the incidence and intensity of D, while people figure out their main intolerances/triggers. It does not help the gut heal.

The symptoms you have, pain, fatigue, etc, is being caused by something you are ingesting/ having contact with that you are reacting to. Eg, food, stress, environmental trigger.
Histamine/mast cell may also explain some of the ongoing symptoms, have you tried antihistamines?

Regardless, the best way to reduce inflammation and heal is to follow bland, low fibre, well cooked, low inflammation eating plan. take good doses of vit D3 and magnesium, be patient, minimise all major triggers.

there are some C dominate MC'ers trying LDN, they may chime in.
Gabes Ryan

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tex
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Post by tex »

Jonas wrote:With remission means when all the symptoms the disease can cause or is it mainly that it no longer has any diarrhea?
Remission means that all symptoms of the disease should be controlled. In some cases control is not 100 % for all symptoms (because there may be other autoimmune issues present, but control should be close enough to complete to allow one to resume an almost normal lifestyle again (except for the diet considerations).
Jonas wrote:Can Entocort reset food sensitivitys? (Because the mask sensitivities in tests)
When the genes that predispose to MC are triggered, the genes that predispose to gluten sensitivity are also triggered, and that gives us permanent food sensitivities from that point on. Since Entocort cannot reset the genes, it cannot reverse food sensitivities (it can only mask them for as long as it is used).
Jonas wrote:Do you think that LDN a better first choice if you do not have diarrhea as the main symptom?
It's certainly possible that LDN might work better in that situation. Entocort will relieve the other symptoms that you named in your last post, but it will also cause constipation if you do not have diarrhea to begin with.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Jonas »

Entocort will relieve the other symptoms that you named in your last post
So you meen it can help somewhat with the back pain, sore hands, feet, neck and so on?
but it will also cause constipation if you do not have diarrhea to begin with
If I get constipated, then I have to cut back on the dose so that I only take it every two or three days, or even five days in between. Right?

I guess the smartest thing to do is start with the medicine that has the least side effects (if you are forced to take medications). I my case (that don't have bad D) that would be.
1. Antihistamins, Cromolyn S. (for Mast. E)
2. LDN
3. Entocort
4. Methotrexate
5. Anti-TNF (last resort)

Thus that seem to be a correct assumption?
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tex
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Post by tex »

Jonas wrote:So you meen it can help somewhat with the back pain, sore hands, feet, neck and so on?
Yes. That type of pain is usually caused by inflammation. Corticosteroids help to suppress inflammation, wherever it might be.
Jonas wrote:If I get constipated, then I have to cut back on the dose so that I only take it every two or three days, or even five days in between. Right?
The labeled dose is 3 capsules per day, so at first you would just reduce the daily dose from 3 capsules down to 2 or 1, depending on your results. The dosage reductions that you mentioned would typically be made later.

Methotrexate and Anti-TNF medications are powerful immune system suppressants. Before I tried either of them, I would consider another immune system suppressant, azathioprine (sold as Imuran in the U. S.).

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Jonas »

I would consider another immune system suppressant
Why is Imuran (Imurel in Sweden) better than Methotrexate? Thus it have less side effects or is better in another way?
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tex
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Post by tex »

That's just my personal opinion, based on the experiences of people I know personally, and members of this discussion board. Of course the people I know who are using (or were using) methotrexate, have not significantly changed their diet, whereas those taking Imuran (who are members of this board), have made diet changes. We have several members of this discussion board who are satisfied with their Imuran treatment.

By contrast, I don't know anyone who has successfully gained long-term control of any autoimmune issue while they were using methotrexate, but I know of 2 or 3 whose disease continued to progress (none of them were treating MC, however — most were treating rheumatoid arthritis). In most cases, methotrexate would seem to work for a while, and then lose effectiveness.

Of course that's very common with using medications to treat AI issues. Virtually everyone who climbs onto that merry-go-round goes from their first powerful drug to increasingly more powerful drugs, and 1 by 1 the drugs eventually stop helping, until eventually their doctor runs out of drugs that can be prescribed. Those who change their diet are usually able to find relief, and the medications work much more effectively for them.

As I wrote in the book, it is quite rare for a GI specialist to prescribe methotrexate to treat MC. While it isn't exactly common, it definitely is not rare for a doctor to prescribe Imuran to treat MC. Surely there is a reason for that.

We have several members who have used Anti-TNF medications, and as far as I am aware, they are still using them. They were taking the medications to control other issues, such as psoriatic arthritis, and those problems were reasonably well controlled. However, none of them (not a single member) were ever able to successfully control their MC by using an Anti-TNF drug, as far as I am aware. In fact, since 1 or 2 members reported that their MC symptoms were much worse for a few days or more after they received their medication infusion, it appears that Anti-TNF medicatins may actually trigger MC reactions.

Your results might be completely different of course, since no 2 cases are just alike. The primary concern with any of the medications in this class is the possibility of the development of cancers (especially leukemia) and life-threatening infections. The risk is relatively low, but it does exist, and doctors tend to downplay it.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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