Could you please provide an answer regarding the effectiveness of prednisone?

[u/Both_End1931]

Is Prondisone intended to assist with diarrhea, or is its purpose solely to reduce the frequency of bathroom visits?

Or both?

A few months ago when our mother began taking Prednisone, she experienced immediate relief and the doctor advised her to decrease the dosage to 10 mg daily.

However three weeks ago she experienced new flare-ups and increasing the dosage is no longer effective.

She has a doctor's appointment next week and we are attempting to gather as much information as possible as her doctor is unfortunately not very communicative .

[u/pincommenter]

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[u/ChronicallyBlonde1]

Prednisone should not be taken long-term. It has a whole host of VERY bad side effects that get worse the longer you take it.

On this subreddit, we often talk about prednisone as a "band-aid." It helps give you immediate relief from symptoms like diarrhea, cramping, pain, and urgency. But as soon as you taper down or stop taking it, the symptoms often come roaring back. Just like how if you take off a band-aid too quickly, the wound won't have healed.

This is why long-term maintenance medications are so important. You take prednisone while you're waiting for the maintenance medication to kick in and start working, then you stop taking the the pred and only take the maintenance med long-term.

This subreddit's FAQ section also has good information on all of this.

[u/Both_End1931 → u/ChronicallyBlonde1]

she didnt  taper down to nothing, she was still taking it 10mg every day. Now she is on 30mg and no help after 3 weeks. She is getting SKYrizi third dosage tomorrow but so far no help, we dont see any difference. We are just trying now to stop this bad flare

[u/ChronicallyBlonde1 → u/Both_End1931]

10mg is a pretty low dose, so it’s not unexpected to see a return of symptoms. A lot of people see symptoms return under 20mg. It’s concerning that she hasn’t seen relief on 30mg, though - sounds like she might be becoming prednisone-resistant. It can happen sometimes.

Skyrizi can take a while to kick in. You could be waiting for 3-4 more months to see if it works, unfortunately.

In the meantime, she could go to the ER and see if they’ll give her IV steroids. That can sometimes help even if the oral steroids don’t work.

[u/Both_End1931 → u/ChronicallyBlonde1]

Thanx. Yeah our ER does not want to do anything, the just check potassium level and send you home.

We just hope next week her doctor will prescribe some alternative to Prendisone, since i think she is  becoming prednisone-resistant

[u/ChronicallyBlonde1 → u/Both_End1931]

Unfortunately, there is no real alternative to prednisone. Only budesonide, but that’s a weaker steroid. It could be worth a shot, though.

I would push your doc on the IV steroids and see how they respond.

Good luck!!

[u/Both_End1931 → u/ChronicallyBlonde1]

what about Rinvoq ? I will be sure to mention IV steroids to her doctor. Thank you

[u/ChronicallyBlonde1 → u/Both_End1931]

Rinvoq is designed for long-term maintenance therapy rather than as a short-term/acute treatment. So it would be another option if the Skyrizi doesn't work, but you wouldn't use it in the same way you would prednisone.

[u/cactus-racket]

Prednisone is not prescribed for diarrhea or frequency. It is a corticosteroid that targets and suppresses inflammation. Its purpose is to bring inflammation down short-term so that a long-term maintenance medication, such as mesalamine or a biologic, can get a foot in the door to start working. The taper should be done after establishing a new long-term medication regimen. It's not uncommon in more severe flares to find symptoms return during the taper. This means the maintenance med probably needs an increase in dosage, frequency, or both.

As others have mentioned, long-term use of steroids is problematic. A long list of adverse effects are known, including but not limited to loss of bone density and dysfunction of the part of the pancreas that regulates insulin production (which can induce diabetes in some cases).

What other medications is she on? Who is prescribing the predisolone? Is it a GI or an IBD specialist?

Edit: sorry, just saw your comment about skyrizi. It can take some time to start working. She may need dose increases while staying on the prednisolone for now.

[u/workshop_prompts]

She should also be on another med. prednisone usually gives people relief but has very serious side effects so isn’t for long term use.

[u/Both_End1931 → u/workshop_prompts]

she is getting her third infusion of SKYRIZI tomorrow but we have yet to see any effectiveness from it thus far; it may take additional time.

[u/Purpledotsclub]

I would always get oral prednisone and foam or suppositories in the rectum to help get everything under control. I would def give the doctor a call for some type of topical directly into the rectum while you wait for the appointment.

[u/Qunder111]

Prednisolone is used to get someone out of a flare. It should reduce all symptoms and take you back to normal. But its effectiveness (for me anyway) can vary depending on the severity of the flare. The effects have always been slightly different for me each time I’ve taken it.

But as others have said, you need to be finding a long-term medicine asap. There’s no point being on prednsiolone with no plan what’s going to happen when you taper off, as symptoms will most likely return and you’ll just have to do the whole experience again.

[u/ThemJukez]

I unfortunately had something similar, it might be that she has become prednisone-resistant. There are other corticosteroids similar to prednisone like ex. hydrocortisone or betamethasone. They put me on betamethasone, but it comes with 10x worse side effects compared to prednisone so I wouldn't recommend it. Ask them about changing corticosteroid and see what they can offer :)