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01-12-2013, 09:38 PM   #1
eastwood
 
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Help! My flare up (Prednisone)

So I've been flaring about 2 weeks now and I've been on Prednisone for 7 days (20 MG a day). I have two questions... First, Is (20 MG a day) strong enough for a bad flare up? Second, Is it normal to have extreme cramping near my pubic region that last about 30 seconds to a minute? The cramps are so severe that I double over in pain. I've had Crohn's for a year and this is my first flare since being diagnosed. Please help! This is the worst pain I've ever felt.

My weight 205
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Last edited by eastwood; 01-12-2013 at 10:42 PM.
01-12-2013, 10:10 PM   #2
Jennifer
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Hi eastwood!

If its been 7 days already and you haven't noticed improvement then 20mg is likely too low of a dose as Prednisone tends to start working within 3+ days (unless it was given via IV, then its sooner). Usually for me during a bad flare I'd take 50-60mg and that was for an underweight child. I'd contact your GI and ask if they'd be willing to up the dose so you can get some relief soon.

Where is your Crohn's located? Are you on any other medications?
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Diagnosis: Crohn's in 1991 at age 9
Surgeries: 1 Small Bowel Resection in 1999; Central IV in 1991-92
Meds for CD: 6MP 50mg
Things I take: Tenormin 25mg (PVCs and Tachycardia), Junel, Tylenol 3, Omeprazole 20mg 2/day, Klonopin 1mg 2/day (anxiety), Restoril 15mg (insomnia), Claritin 20mg
Currently in: REMISSION Thought it was a flare but it's just scar tissue from my resection. Dealing with a stricture. Remission from my resection, 17 years and counting.
01-13-2013, 12:00 PM   #3
eastwood
 
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Hi eastwood!

If its been 7 days already and you haven't noticed improvement then 20mg is likely too low of a dose as Prednisone tends to start working within 3+ days (unless it was given via IV, then its sooner). Usually for me during a bad flare I'd take 50-60mg and that was for an underweight child. I'd contact your GI and ask if they'd be willing to up the dose so you can get some relief soon.

Where is your Crohn's located? Are you on any other medications?
My flare up is in my colon.
Prednisone 20mg a day... last night I took a extra 40mg for a total of 60mg
pentasa 4000mg a day
Flagyl 1500mg a day
01-13-2013, 08:14 PM   #4
hawkeye
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It usually kicks in for me within 3 days or so and usually with 40 mg. That being said when I was first diagnosed and tapering, I could not get below 40 mg without things flaring up again.
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01-13-2013, 10:35 PM   #5
Michelle89
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I am currently on 40mg Prednisone for a flare. I have been on it for two weeks and I am not sure it's doing anything - except giving me side effects. Although I'm not having pain. The last time I took Prednisone it worked a lot faster than this and I think it was a lower dose then. I'm nervous I'll end up with surgery if it doesn't start working. I have a follow-up appointment tomorrow.....

Hope you are starting to feel some relief, if not I'd call the dr. if you are still in that much pain.
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Diagnosed Crohn's Disease 12/2000
Emergency Resection at Terminal Ileum in 12/2000
Past Meds:
Pentasa
Entocort
Prednisone when in flare
Currently on:
Imuran (100mg)
Prednisone for Flare
Humira
Also Taking: Vitamin D3, folate, Magnesium, Omega-3's, probiotic, general muliti-vitamin
01-13-2013, 11:04 PM   #6
Jennifer
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Prednisone 20mg a day... last night I took a extra 40mg for a total of 60mg
Did your doctor suggest to do this? Be careful if you're self medicating with Prednisone. No matter what dose you cannot simply stop taking it. So if you're at 60mg now then you'll likely need to taper from that dose rather than the original 20mg which your GI prescribed. You need to watch out for Adrenal Insufficiency/Crisis while tapering and definitely if the dose is fluctuating by upping it and lowering it suddenly, which can be deadly. If your GI did not suggest to up the dose to 60mg then you need to call them and let them know so they can help you plan for how long you'll be on that dose and how to taper properly.

If your GI suggested to up the dose then I hope it works to get your flare under control. Please keep us posted.
01-13-2013, 11:21 PM   #7
CrohnsChicago
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prednisone usually kicks in for me after two days. You are most likely on too low of a dose. Let your doctor know about this as well as your symptoms so adjustments can be made to your treatment.

I think starting in the 30s/40s range is more common (My first flare I started at 35mg, 2nd flare started at 30mg).
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Crohn's-Colitis May 2012
Current Meds:
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01-15-2013, 11:43 PM   #8
eastwood
 
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I am currently on 40mg Prednisone for a flare. I have been on it for two weeks and I am not sure it's doing anything - except giving me side effects. Although I'm not having pain. The last time I took Prednisone it worked a lot faster than this and I think it was a lower dose then. I'm nervous I'll end up with surgery if it doesn't start working. I have a follow-up appointment tomorrow.....

Hope you are starting to feel some relief, if not I'd call the dr. if you are still in that much pain.
Sorry to hear your not responding well to the Prednisone. What kind of sides are you getting? I also fear surgery myself and im going to the GI tomorrow.
01-15-2013, 11:51 PM   #9
eastwood
 
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Did your doctor suggest to do this? Be careful if you're self medicating with Prednisone. No matter what dose you cannot simply stop taking it. So if you're at 60mg now then you'll likely need to taper from that dose rather than the original 20mg which your GI prescribed. You need to watch out for Adrenal Insufficiency/Crisis while tapering and definitely if the dose is fluctuating by upping it and lowering it suddenly, which can be deadly. If your GI did not suggest to up the dose to 60mg then you need to call them and let them know so they can help you plan for how long you'll be on that dose and how to taper properly.

If your GI suggested to up the dose then I hope it works to get your flare under control. Please keep us posted.
No, my doctor did not tell me to take the 60mg but he is not helping me at all. I have a appointment tomorrow with him and will be the last visit with him until next week when I get a new GI. I'm hoping he can give me more prednisone so I can taper of the correct way. Thanks for your concern about tapering and I'm aware that you cant just stop taking prednisone.
01-15-2013, 11:57 PM   #10
Michelle89
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eastwood: My GI gave me the all clear to start tapering down my prednisone I guess I'm about to find out how well it is or isn't working..... I was/am getting shakes, hot flashes, rapid heart beat, sleeplessness, and very quick to go off on people - which is SO not like me!

I hope you get a plan in place tomorrow from your GI that brings relief from your pain and no surgery will be needed!
01-15-2013, 11:59 PM   #11
eastwood
 
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prednisone usually kicks in for me after two days. You are most likely on too low of a dose. Let your doctor know about this as well as your symptoms so adjustments can be made to your treatment.

I think starting in the 30s/40s range is more common (My first flare I started at 35mg, 2nd flare started at 30mg).
Yea at first he was he giving me to low of a dose of pentasa and now he tried to give me to low of a dose of Prednisone Ive been trying so hard to find a new GI and have a appointment next week with the new GI. When I first told him I was having a flare up he sent me for a scan and would not give me any meds and said the scan would take over a week before he would get back with me on the results. I blame him for how bad my flare up is now!
01-16-2013, 12:02 AM   #12
eastwood
 
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eastwood: My GI gave me the all clear to start tapering down my prednisone I guess I'm about to find out how well it is or isn't working..... I was/am getting shakes, hot flashes, rapid heart beat, sleeplessness, and very quick to go off on people - which is SO not like me!

I hope you get a plan in place tomorrow from your GI that brings relief from your pain and no surgery will be needed!

Well i hope your taper goes well! I know all about the quick to go off on people while on prednisone. lol
01-16-2013, 12:07 AM   #13
eastwood
 
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eastwood: My GI gave me the all clear to start tapering down my prednisone I guess I'm about to find out how well it is or isn't working..... I was/am getting shakes, hot flashes, rapid heart beat, sleeplessness, and very quick to go off on people - which is SO not like me!

I hope you get a plan in place tomorrow from your GI that brings relief from your pain and no surgery will be needed!
Did you have very bad cramping? My was so bad this time, and it still hurts time to time. I think the 60mg of prednisone is helping but im still not well.
01-16-2013, 12:19 AM   #14
Michelle89
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Did you have very bad cramping? My was so bad this time, and it still hurts time to time. I think the 60mg of prednisone is helping but im still not well.
I had extremely sharp, stabbing pains with a bit of cramping. When I'm having a flare, the pain is just as bad as the worst child labor pains in my opinion. I actually use the labor breathing to get through flare pains. Prednisone did stop my pains though, so I'm hoping it's working and that no scar tissue is causing my strictures.

It's good you have an appointment tomorrow especially if you are still having some pain. Post an update!
01-18-2013, 07:17 PM   #15
eastwood
 
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I had extremely sharp, stabbing pains with a bit of cramping. When I'm having a flare, the pain is just as bad as the worst child labor pains in my opinion. I actually use the labor breathing to get through flare pains. Prednisone did stop my pains though, so I'm hoping it's working and that no scar tissue is causing my strictures.
It's good you have an appointment tomorrow especially if you are still having some pain. Post an update!
Hi eastwood!

If its been 7 days already and you haven't noticed improvement then 20mg is likely too low of a dose as Prednisone tends to start working within 3+ days (unless it was given via IV, then its sooner). Usually for me during a bad flare I'd take 50-60mg and that was for an underweight child. I'd contact your GI and ask if they'd be willing to up the dose so you can get some relief soon.

Where is your Crohn's located? Are you on any other medications?
It usually kicks in for me within 3 days or so and usually with 40 mg. That being said when I was first diagnosed and tapering, I could not get below 40 mg without things flaring up again.
prednisone usually kicks in for me after two days. You are most likely on too low of a dose. Let your doctor know about this as well as your symptoms so adjustments can be made to your treatment.

I think starting in the 30s/40s range is more common (My first flare I started at 35mg, 2nd flare started at 30mg).
To keep you guys up to date, My GI has me on 60mg of prednisone and I will taper all the way down to 10mg. I'm still very ill and much in pain. Today was my first dose of 50mg and will be on 50mg for two weeks. I PRAY that I can get this flare up under control with not having to go to the hospital! This is my first flare up since being diagnosed one year ago. I think I might go crazy if I eat another plain food lol. I'm sure you guys know what i mean. All I eat is chicken and rice with potatoes and green beans. What do you guys eat when your flaring and is there any food that has flavor that i can eat right now??? Like something sweet that wont hurt me....

Last edited by eastwood; 01-20-2013 at 01:07 AM.
01-18-2013, 07:43 PM   #16
CrohnsChicago
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I make clean tacos. I boil and shred chicken, and top it on a tortilla with diced tomatoes, red onions, cilantro lime juice and the TINIEST bit of cheese.

I also make a white bean chicken chili. I have had one person on here try the recipe and they love it! Its really good:
http://www.thegraciouspantry.com/cle...chicken-chili/

Basically any variation of chicken I could come up with I tried. As well as fish. I like to eat lemon pepper salmon and rice.

For sweet (im doing this one right now), you can try frozen blueberries dipped in greek yogurt. I took plain greek yogurt, mixed honey in it then you take two toothpicks and cover the berries in the yogurt mix. put them in the freezer for about an hour and they are ready to snack on or place into a baggie in the freezer for later
01-18-2013, 08:19 PM   #17
eastwood
 
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I make clean tacos. I boil and shred chicken, and top it on a tortilla with diced tomatoes, red onions, cilantro lime juice and the TINIEST bit of cheese.

I also make a white bean chicken chili. I have had one person on here try the recipe and they love it! Its really good:
http://www.thegraciouspantry.com/cle...chicken-chili/

Basically any variation of chicken I could come up with I tried. As well as fish. I like to eat lemon pepper salmon and rice.

For sweet (im doing this one right now), you can try frozen blueberries dipped in greek yogurt. I took plain greek yogurt, mixed honey in it then you take two toothpicks and cover the berries in the yogurt mix. put them in the freezer for about an hour and they are ready to snack on or place into a baggie in the freezer for later
Thanks Ill give these things a try
01-18-2013, 10:37 PM   #18
Michelle89
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I can't eat hardly anything during a flare. White toast, saltine crackers, ensure, mashed potatoes, most liquids. I have been feeling a bit better so I have added in some salmon and rice for dinner, chicken (which I know you are sick of, lol) applesauce and canned peaches. I can't have any fresh fruits or veggies at all. I also am dealing with strictures so I have to avoid anything with seeds, nuts and skins. Eating is definitely not a fun, social thing anymore :-/
01-18-2013, 11:15 PM   #19
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To add flavor to chicken breast I cut the breast into chunks and marinate it in lemon juice (you'll see the edges turn white, takes about 10-15 minutes). Add a little salt and pepper while cooking (could use a little tiny bit of butter or oil in a frying pan or bake it) and put that on top of rice with a tiny bit of butter, salt and pepper on the rice. You can throw veggies in there that you know you can eat and cook them with the chicken, even marinate it with the chicken.

During a flare I follow the Low Residue Diet: http://www.crohnsforum.com/wiki/Low-Residue-Diet You can make just about anything low residue.

For sweet what I did was take a couple pieces of bread, put a little butter on top and sprinkle on cinnamon and sugar then bake until the bread is toasted. Makes the house smell nice at least. :P I also ate canned peaches. Honey on biscuits is good.
01-20-2013, 12:08 AM   #20
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New update on my flare up. Last night was the worst night off my life! I got up in the middle of the night at least 15 times to run to the bathroom. So I'm in the hospital now and there giving me Solu medrol 125mg to help with the inflammation. I don't know how long i'll be here, it just depends on how I respond to the Solu medrol. Ill keep you guys updated.
01-20-2013, 10:46 AM   #21
barelyalive
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May I ask what all of your flare symptoms are?

My Crohn's is in my colon right to the rectum. I also have a hiatal hernia, IBS and Barretts esophagus.

I am in constant pain, with intermittent severe cramping, passing even a tiny blot of mucus/blood is excruciating. I have been bleeding a lot the last few days.

Is predisone the only hope for relief? I did vivonex for two days and the perpetual pain was relieved but still had mucus and bleeding issues, worst off I developed an intense incurable headache and had trouble sleeping - I am an corporate accountant who needs to concentrate this time of year - so I went back to eating gentle foods on Friday.

Thanks
Hope you feel better!
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01-20-2013, 03:55 PM   #22
eastwood
 
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May I ask what all of your flare symptoms are?

My Crohn's is in my colon right to the rectum. I also have a hiatal hernia, IBS and Barretts esophagus.

I am in constant pain, with intermittent severe cramping, passing even a tiny blot of mucus/blood is excruciating. I have been bleeding a lot the last few days.
Is predisone the only hope for relief? I did vivonex for two days and the perpetual pain was relieved but still had mucus and bleeding issues, worst off I developed an intense incurable headache and had trouble sleeping - I am an corporate accountant who needs to concentrate this time of year - so I went back to eating gentle foods on Friday.
Thanks
Hope you feel better!
Yes, my symptoms are extreme crapping in my pubic region and the pain can come and go about 20 times a day. Since being in the hospital they have me on a strong pain med called Solu-Medrol that helps so much with the pain.

Prednisone is not the only relief but you would have to go to the hospital for some days to get the stronger corticosteroid and if that does not help with then a few days they would probably bump you up to a immune system suppressing drugs, witch will be my next step if I don't get better from the solu-medrol 125mg.

So how long have you been flaring and are you getting better with just the prendisone?
Hope the best for you
01-20-2013, 04:07 PM   #23
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Keep us posted eastwood. What medications have been suggested if the solu-medrol doesn't do the trick?
01-20-2013, 04:58 PM   #24
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Keep us posted eastwood. What medications have been suggested if the solu-medrol doesn't do the trick?
Well this is my second day on slou-medrol and My GI wants to try this for 3 days total and see if my blood work shows that the inflammation is getting better then move up to Humira if not.
01-20-2013, 05:35 PM   #25
Jennifer
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And if it does work then your GI thinks that your current treatment plan was working fine? They don't want to add anything or switch to something else to keep this from happening again?
01-20-2013, 06:05 PM   #26
eastwood
 
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And if it does work then your GI thinks that your current treatment plan was working fine? They don't want to add anything or switch to something else to keep this from happening again?
No, I was on pentasa for a year and i've had a few problems here and there but this was the worst of all flare ups so far. So to answer your question there going to put me on Humira or Remicade. But sounds like to me from what we have talked about ill probably go straight to Humira.
01-20-2013, 08:36 PM   #27
Michelle89
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New update on my flare up. Last night was the worst night off my life! I got up in the middle of the night at least 15 times to run to the bathroom. So I'm in the hospital now and there giving me Solu medrol 125mg to help with the inflammation. I don't know how long i'll be here, it just depends on how I respond to the Solu medrol. Ill keep you guys updated.
Sorry to hear you ended up in the hospital, but I hope there you will find some answers and a plan to attack this thing. Best wishes!
01-20-2013, 09:00 PM   #28
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Sorry to hear you ended up in the hospital, but I hope there you will find some answers and a plan to attack this thing. Best wishes!
Thanks for your support! I'm staying positive and I know it will all work out .
01-21-2013, 11:49 PM   #29
eastwood
 
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Sorry to hear you ended up in the hospital, but I hope there you will find some answers and a plan to attack this thing. Best wishes!
Im still here in the hospital and Im praying that my blood work shows in the morning that the inflammation is going down!
01-22-2013, 12:13 AM   #30
Michelle89
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Im still here in the hospital and Im praying that my blood work shows in the morning that the inflammation is going down!
Will be praying with you. Hopefully you can go home soon with a plan of action in place that will help you. FYI: if your blood work is painful I learned that making sure your arm is warm before they draw makes it go less painfully not sure if it's something weird that just works for me but I'd always make sure I had those wonderfully warm hospital blankets on before they came in
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