# Prednisone for IBS D



## jmc09 (Oct 5, 2009)

I had an appointment with the Professor who treats my IBS,only my second time seeing him in 18 months due to a large number of people who want to see him,I was explaining my poor reaction with various tablets,Imodium,ADs and Codeine lately and he mentioned treating some of his patients with steroids, prednisone I assume.I've done a bit of research into some peoples experiences with prednisone and most of these seem very,very positive and largely from people who were treated for other symptoms and had a very beneficial side effect of calming down their IBS.Considering the modern idea is that IBS is caused by some sort of inflammatory reaction I reckon this may support it,in some cases at least.Its something I would be willing to try,at a very low dose of course, in the future.Has anybody else had any experiences with prednisone?


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## BayRat (Mar 28, 2011)

Look into Entocort (budesonide). It was developed as a potential improvement to other steroids. It has fewer negative side effects and lower risks than other 'roids. There's fairly good data for use in IBD patients, but not a great deal with IBS yet. Still, more than a few GIs are trying it out on IBS patients. Like most steroids, it's hit-or-miss. If inflammation isn't the problem then no steroid will help. If it's successful, many people have remained on a low minimal dose for 4+ years or so.


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## jmc09 (Oct 5, 2009)

The only thing that ever helped me live a largely normal life since being diagnosed was Sulfasalazine,which is an anti inflammatory drug yet inflammation was only diagnosed once many years ago and a very minor inflammation too.I will look into Entocort in the near future if things dont improve,thanks for your advice.


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## Michealleo (Aug 4, 2011)

yes i know immodium dont work for everyone . In this disorder every individual has to treat his or her symptoms accroding to their conditions . Well prednisone is last way to treat inflammation and crohnic dirrhea .


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## DeeDee (Sep 30, 2004)

I would never use prednison to treat IBS. I use prednisn as I have plymyigia, and to telyou the trth, predison is a woder drug, but it has so many side effects, I wil be so gad to get off of it. aznd it puts weight on you. I have gained forty pounds since startig with predison in January. I hate it,and even thughit helps me. I want off of it now. that is my experience


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## overitnow (Nov 25, 2001)

Man, I have been so good for so long treating my inflammation with flavonoid supplememtation, that I simply cannot come up with a single reason why you would want to use a steroid before at least trying this alternative. (I need an emoticon that beats its head into the wall...)Mark


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## jmc09 (Oct 5, 2009)

Mark,with respect,here in the UK if we are on benefits or low paid we can get free prescriptions,this applies to me. I cannot afford to pay for supplements,flavanoids etc,no matter how effective they may be.I am currently trialling mesalamine for IBS but the first lot of sachets ive been given are doing nothing at all for me whatsoever so maybe the second lot will help,i hope so anyway.I think everybody is different and must try a whole range of drugs to see what suits them so i would never say to any sufferer not to try a certain medication or treatment and if something works then thats fantastic and a real help to improve a persons quality of life.


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## overitnow (Nov 25, 2001)

With equal respect, when I started supplementing I was working a commission job, could not really work effectively for even an 8 hour day, and I wasn't earrning even minimum wage. A year later my D was 90% resolved and I was working a full time and a part time job, allowing me to make an additional $5000 a year. As far as steroids, I once had a killer case of eczema that was triggered by chemicals from work. I had been using cortisone which had lost its effectiveness. My Dr at the time said he had nothing but stronger steroids to offer--the kind that would be illegal were I to be an athelete--and suggested I see a naturopath. (That involved a 3000 mile flight, as I was living in Northern Canada at the time.) That was incredibly expensive; but it was the first occasion when I began to see any improvement anywhere, and it is hard to be in retail when your hands are cracking and bleeding. So I stand by my statement. The whole point of continuing to say this is that I have been able to treat my inflammation for over 10 years for about $40 a month, without the kinds of side effects you may get from pharmaceutical steroids. That is a couple of bottles of wine or 4 packs of cigarettes or dinner out once on a monthly basis. I avoid all prescription medicines unless they are for a short term treatment; and my health, which was once in the toilet, is aces. To say that prednisone is the only alternative, as Michaello states, is simply not true. Mark


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## jmc09 (Oct 5, 2009)

I didnt say prednisone was the only alternative,i said it was one of very few i havent tried and would be willing to give a go if my current drugs trial for mesalamine doesnt work out.I would probably try entocort first given that its one of the milder forms of steroid treatment.You have mentioned that you have or had cholesterol issues and were a smoker,both of these arent issues for me.If a treatment for me cost 40 pounds,using dollars as pounds to keep things simple,i simply couldnt afford it,full stop, so unless the medical industry prove conclusively that products like yours help everybody,some of us have to deal with whatever we can to improve our quality of life.Its also worth mentioning that products that are given approval in USA/Canada can take many years to make it to Europe and the UK in particular.Good luck with your continued good health.


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## BayRat (Mar 28, 2011)

overitnow said:


> yes i know immodium dont work for everyone . In this disorder every individual has to treat his or her symptoms accroding to their conditions . Well prednisone is last way to treat inflammation and crohnic dirrhea .


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## BayRat (Mar 28, 2011)

jmc09, The 5-ASA family of meds (Asacol, Pentasa, etc.) has largely replaced your former med. of Sulfasalazine due to the discovered downsides of it's long term use. It can take weeks, up to 8, to reach a good steady blood level and make a difference. Be patient. Standard starting dose is 3 caps 3x a day. It's not all that unusual to escalate to 4 or 5 caps 3x a day, if necessary.I took Asacol for about a decade. (I'm diagnosed with Microscopic Colitis and have a sibling with Crohn's. We share a lot of info.) It became less effective over the years and required periodic dosage escalation. But hey, I bought myself 10 years of at least some kind of effective help. I've also tried out Budesonide. First run was a miracle. The GI explained that any benefits may take several weeks to show, but I was symptom free in 24 hours! As I tapered off (9mg 1x a day, to 6mg, then 3mg) my issues increased. Within 2 weeks of cessation I was as sick as ever. The second run never achieved anywhere near those great results and I decided that the risk:benefit was no longer in favor of continuing. This was before GIs began allowing patients to remain indefinitely on a low maintenance dose (3mg 1x a day). I'd give it another go but my issues aren't all that troubling lately.If you're dead set on trying a corticosteroid, educate yourself about budesonide and consult with your GI. It's a nearly perfectly designed 'roid for GI issues with inflammation as a treatable condition. It's been out for about 8(?) years now, and has a pretty good record. Yes, of course it has risks, but far less than, say, Prednisone. The risks and potential damage from Prednisone increase with the duration of treatment. That doesn't appear to be happening with budesonide. Maybe, in more time they'll find the dark side of budesonide. That's your choice and risk to take, no one can choose for you. (unless of course your GI says it's contraindicated for you for some reason) When I took it, it was hair raising expensive, thank G-d for health insurance. Not sure, but I believe the patent expires in Feb. 2012 on Entocort and a cheaper generic version will become available. Astra Zeneca pushed out an EC version of Entocort in an attempt to retain some market share with the delivery system tweak. Standard Big Pharma shenanigans.If they were able to visualize inflammation once, as you posted, then it's a possibility that you may have some form of an IBD. It's true that micro-inflammation has now been visualized in some IBS patients. But if they saw it without using the very advanced recent techniques, it might not be simple IBS. Crohn's can't always be consistently visualized. Microscopic colitis can be a transient condition (Lymphocytic or Collogenous, I've been Dx'd as both at different times) that requires numerous biopsies to positively ID.Being diagnosed with an IBD isn't much better than having IBS. There's no cure for MC or Crohn's either, and precious little help for UC. Different label, same dead end. Folks with IBDs would be delighted to find a simple stalemate. An IBD diagnosis would just mean that your GI can authorize bigger gun meds.Wow, I lose cool points for such a loooong post.


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## jmc09 (Oct 5, 2009)

BayRat,thanks for your information its very helpful.I was diagnosed with colitis in '92 with a colonoscopy but since then numerous colonoscopies have shown no inflammation,therefore ive been classified as an IBS patient.Like i said previously the anti inflammatories used for IBD are the only things which have ever helped my condition long term while imodium etc seem to have only a short shelf life.I tried ondansetron with no real improvement as well so i believe the anti inflammatory treatment is my best bet in the long term.BTW,is your IBD and your siblings,classed as an auto immune condition?


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## BayRat (Mar 28, 2011)

I hope I've been of some small help to you. My own nightmare began 12 years ago. Nice way to enter the 21st Century, eh? If it wasn't for my very determined and proactive GP I might have gone for many years with no focused help. MC is often missed, or misdiagnosed, and many patients suffer horribly for years before getting a proper diagnosis and treatment.What kind of colitis did they diagnose in you? Did they take biopsies then, or in any colonoscopy thereafter? Currently, biopsy is the only diagnostic that can positively ID MC. And, with MC, the vast majority have waxing and waning periods of symptoms, some periods of spontaneous or medically induced remission can last a decade. Entocort's original aim was for a tapering 4 month treatment of corticosteroids in the hopes of inducing such a remission (a pulse treatment). I've been most unfortunate in that my symptoms have rarely let up without high doses of meds. Sure, a few days, maybe two weeks, but that's all.With your history, I don't think that you're in for a hard fight to try the budesonide, if that's your choice. Some of the more enlightened GIs are cautiously prescribing it for some IBS patients that respond to anti-inflammatory meds. You may need some heavy persuation to get a maintenance dose approved, but cross that bridge when/if you get there. No sense worrying about it now, the budesonide may not work for you. Stick with the Mesalamine for a while, give it a chance. It's a much safer anti-inflammatory for long term maintenance than any corticosteroid, and it's been around a great deal longer so there's a lengthy safety profile and less controversy. It's also far less expensive so your health insurance is less likley to squawk. The Ondansetron you mention is mainly for nausea working via serotonin receptors and has no anti-inflammatory properties that I know of. It can slow down intestinal contractions/motility, but does nothing for inflammation.But no, neither of us has ever been classified as having an immuno disease. My only blood relative that has is my mother, with Rheumatoid arthritis, largely believed to be a "chronic, inflammatory autoimmune disorder..." IBD/IBS is common in my family. Interestingly, a cousin with MC spent many months in a Houston hospital due to a cascading organ failure episode that was never really pinned down as to the cause. It took very strong immunosuppressants to get it back under control. She barely survived, and thank G-d she did. It does make me wonder though.My sibling with Crohn's does currently take 6-mp (6-mercaptopurine) which is an immunosuppressive med. Been on it for about 3 years now, and so far, it's been the most successful med. for him The 6-mp has slowed the disease progression down, but he's still losing the war. There's preliminary discussion of removing portions of his intestines. He'd been on Asacol for a few years prior to the 6-mp. It helped, but not very much. Very funny, we took a trip together once and shared the room. The mornings were a riot with giant bottles of bajillions of clinking/clacking pills and which one is who's? We ended up making one big pile and just took the dose we needed.


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## jmc09 (Oct 5, 2009)

BayRat,my original diagnosis of colitis was diagnosed from tissue samples back in '92,a sigmoidoscopy missed any sign previous to that and so have all successive ones since,about 5 of them.I asked about the auto immune element because sometimes ibds are linked to this,i have 2 sisters with arthritis,started in their twenties and a father with diabetes so i believe there are possibly genetic links yet to be proven.My symptoms havent really changed since the beginning other than my being able to manage my symptoms better due to meds and understanding of the problem.I am a patient at a well renown IBS centre here in the UK with a very forward thinking professor in charge so getting different treatment options should be a little easier than most.Thanks for your information,you appear to be very knowledgeable about bowel conditions despite being a non professional medical person.


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## backtonature (Jul 15, 2011)

I'm also in UK and have not yet managed to get my GP to refer me to a specialist. Is the clinic you attend private or NHS? I'm desperate to find a doctor who understands IBS! My GP has been useless.


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## BayRat (Mar 28, 2011)

jmc09, I thank you for the compliment. Though, based on some of the _professionals_ I've had the misfortune of dealing with, that could be a total diss. Just kidding, can't seem to pass up a chance for humor, which has led to a bumpy, but interesting life







When I saw the word Prednisone I felt compelled to offer what little knowledge I have to aid your quest. Whether or not to try Corticosteroids was once a dilemma I faced also, and may yet again. Like you, I didn't rush into it. What's a few weeks, or months, of research and consideration compared to years of suffering?I have a very open mind towards IBS & IBD. I think that's critically necessary if we're ever to find the answers. The medical establishment sometimes really boggles my mind; They have no idea what it truly is yet they profess with such absolute certitude as to what it's not. Ultra conservative and counterproductive, to say the least. If it's not in the textbooks it doesn't exist. Mind you, the textbooks are a lot of re-re-re-shuffled 50 year old data. So, I'm happy to hear that you're in good hands with a progressive pro-active style of doctor. Such a doctor that thinks outside of the box is a rare thing indeed, of inestimable value to folks like us.Conditions like Arthritis or Rheumatoid Arthritis, or any other immuno conditions, wouldn't exactly shock me as being connected to IBD/IBS. And there _is_ a history of Type II diabetes in my family. I didn't mention it because I didn't think it fit the intent of your question. Father, both G'mas, various Uncles & Aunties. No cousins that I know of, not yet, anyway, the eldest just now entering their 60s. Conversely, we're blessed with absolutely no cancer at all, not a single type that didn't originate with smoking. I suspect that there's no one singular cause of IBD/IBS, that these individual conditions are not so neatly defined, just simply lumped together according to presenting symptoms and diagnostic evidence and thrown into one big basket for reasons of convenience, ignorance and impotence. Likely there's numerous conditions with numerous causes.Edit: Ah, here's the information I'd been thinking of when I mentioned that micro-inflammation has been detected in some IBS patients by using modern techniques. There's many other sources, here's one. Being a long time member here, I'd guess that you're familiar with Bolen's ongoing active coverage of all things IBS.Inflammation and IBS


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## jmc09 (Oct 5, 2009)

Backtonature.I attend the south manchester functional bowel clinic,based at wythenshawe hospital manchester and led by a professor Peter Whorwell,who is a world leader in gastro and bowel conditions especially.If you are close enough ask your GP for a referral.


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## jmc09 (Oct 5, 2009)

BayRat,thanks for that article it makes interesting reading.I've had four instances over the last 12 months where blood tests have shown a high white cell count,indicating infection,yet no reason why, so maybe this research could be my type of IBS?I agree with your comments re doctors too,some of them are really clueless when dealing with IBS and IBDs.Struggling at present as drugs/placebo given to me are doing nothing to improve my condition and i maybe leaning towards anti inflammatories or steroids very soon.


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## BayRat (Mar 28, 2011)

Heh, my WBC has been highly elevated for over a decade. My brother with Crohn's too. Neither of us has ever had a single positive for any blood/fecal/urine/etc tests, not for bacterial, viral, parasite, or aliens. Not even any unusual antibodies, nothing at all, and I've long since lost count of how many of those types of tests I've had. Funny, I'm healthy as a horse other than the MC, always have been.I'm no doctor, but it sure sounds more and more like you don't have _simple_ IBS. Consider a traditional colonoscopy with biopsies. If you can arrange it during a flareup that may help. I've had Upper GI and an Endoscopy, neither of which showed anything of note. Maybe it's not even a primarily gastro disorder you suffer but some auto-immune condition, as you suspect. I know zip about such conditions so I'll not pretend to advise there.


> There are two types of sigmoidoscopy, flexible sigmoidoscopy, which uses a flexible endoscope, and rigid sigmoidoscopy, which uses a rigid device. Flexible sigmoidoscopy is generally the preferred procedure. A sigmoidoscopy is similar to, but not the same as, a colonoscopy. A sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel.


A website/Forum that's dedicated to MC is PerskyFarms - Microscopic Colitis SupportThey've been around quite a while and have some great information on MC. It's actually the only health site/forum I know of that's dedicated to MC. It's a bit small and slow, but does keep up with current information. I learned a lot about real world experiences with budesonide for folks with my particular condition there. One strong suspicion there is that celiac sprue may be connected to MC. Even if it's nor formally diagnosed or detected, that it may be aggravating the condition. The member (owner?) there called Tex, displays a great deal of pharmaceutical knowledge and a very receptive to new information style of thinking. Well, if you're curious, there's the link.


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## jmc09 (Oct 5, 2009)

I'm going to ask my Prof to prescribe a course of budesonide and see how i handle it.I will report back as soon as possible,watch this space.


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## BayRat (Mar 28, 2011)

Please do report back on your experiences and outcome. Sharing solid information is a powerful tool. We, who suffer from these 'mystery' ailments, could use all of the tools we can find.A word of advice - Take it first thing when you arise for the day. Like most/all(?) 'roids, it has a tendency to cause mild mania, and can keep you awake. As to adverse effects, I experienced nothing more than wakefulness and random facial/throat/chest flushes. The flushes were always shortly after dosing. Avoid grapefruit/grapefruit juice while on this treatment.Be wary of prolonged exposure to sunlight. Beware of folks with colds/flu/measles/chicken pox/etc. as your immune response will be (very mildly) suppressed, but compromised nonetheless. If needed, compatible antibiotics are a tough call when on budesonide. I can't even recall the one my GP finally settled on when this need occurred. Likely, there's better info. and options today.Decent information here. It can be pretty scary, but what medication isn't potentially intimidating when properly assessed and explained in detail?I wish you the very best of luck, be it with budesonide or any other remedy you try. But please, for my peace of mind, don't let anything I've said be the deciding factor for you. Thoroughly discuss this with your GI. I don't for a moment think you're that silly and so easily swayed. It's my weakness, or perhaps strength, that causes any potential consequences of my words and deeds to lay heavy on my shoulders.


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## jmc09 (Oct 5, 2009)

Just a quick update on this.Before december 2009 my only problem was IBS D but i developed a urine infection then which hasnt gone away since.My problem is called Epididymitis and is an inflammation of the tube around the testicle.During this time i've been prescribed many courses of antibiotics,none of which have helped my epididymitis but the Cipro and Doxycycline were actually quite beneficial to my IBS and at times caused constipation,the first time i'd ever had that predicament.This problem has been as bad or worse than my IBS,its also causing chronic pain,IBS doesnt really do that to me.Anyway,im waiting for some treatment for this epididymitis,injections actually but my doctor has just prescribed me a very short course of prednisone to see if it helps.Im hoping it has a double whammy effect on both my conditions but i will let people on here know if it helps at all in the coming days.


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## jmc09 (Oct 5, 2009)

Just finished my course of prednisone and it did nothing at all for my IBS.It also did little for my epididymitis either.Another avenue closes.I will try out a course of rifaximin if my doctor will allow me to next.


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