Microscopic Colitis

[Yealink]

I have been recently diagnosed with Microscopic Colitis and have just started taking Budesonide, 2 days ago actually! Started at 9mg and reducing to 6mg then 3mg over 3 months. My question is, is this okay to take with already prescribed Prednisolone for Polymyalgia Rheumatica which started in January this year? Does anyone have any problems with Budesonide and will it clear up the colitis eventually?

[SuzyQ67]

Call your pharmacist, they know medications better than most drs to make sure it's ok. I am thinking it's ok but it doesn't hurt to double check.

[Yealink in reply to SuzyQ67]

Thank you, I’ll have a word.

[saj12]

Little surprised you didn’t discuss with the docs, I would expect that the prednisolone being a far more ‘powerful’ steroid than budesonide would also provide relief for the colitis. I think you need to discuss with the docs.

[bresbo]

I don't believe you should have been prescribed two steroids at the same time. Ask your doctor. And what dose of pred are you on?

[Yealink in reply to bresbo]

I'm taking 5mg Pred for Polymyalgia Rheumatica and have been since January this year, then I was diagnosed with Microscopic Colitis and now taking 9mg Budesonide, the Pred has not helped with the colitis but certainly keeps PMR at bay! The GP's don't seem to be concerned about taking both.

[bresbo]

Okay. Good to know. Cross fingers for you it works on the colitis. Certainly budesonide doesn't act systemically like pred, so you shouldn't notice significant side effects. Two questions, if you don't mind. Have you had PMR for long and have tapered the pred down to 5mg? And which brand of budesonide have you been given? Best wishes.

[Yealink in reply to bresbo]

I started with PMR back in September 2020 but didn't have it confirmed until January 2021, I started on 20mg and reduced to 5mg, now going to start 2.5mg as discussed with the GP. I really don't know the brand of Budesonide as I was only given a weeks supply owing to some confusion with the script from the hospital, just waiting to hear back from them! Best wishes to you too

[bresbo in reply to Yealink]

Thanks for your replies. Do you read the PMR group on HealthUnlocked? I don't think anyone there would believe that a case of PMR could be more or less resolved in 10 months. Two to ten years seems to be more the norm. Do you no longer have any joint pains? Furthermore, I believe that until the advent of budesonide, either pred or the non-steroidal mesalazine used to be the treatment for microscopic colitis. And you're already taking pred. Curious. Are you, by the way, taking additional medication to help prevent side-effects of pred? For example omeprazole against stomach irritation?

[Yealink in reply to bresbo]

PMR does take a long time to burn itself out, I realise that I have been lucky up to now and I asked my GP for a lower dose of 2.5mg to see how I manage and with the budesonide too for colitis. I do not take any other meds, as omeprazole did not agree with me, and could possibly have caused the microscopic colitis, who knows!! I do not have any side effects with pred. Best wishes

[bresbo in reply to Yealink]

Glad to hear your PMR is burning out so quickly. I asked about the omeprazole precisely because of one of its nastier side effects. Yes it can cause/trigger colitis, and so can similar drugs like lansoprazole. It did with me - gave me my first (really horrid) flare. I had had underlying very mild colitis for years beforehand, but it had never caused any problem, and wasn't even medicated. So you may well be correct in pointing the finger at omeprazole.

[Yealink in reply to bresbo]

Also Lansaprazole which I was prescribed and then onto omeprazole, both for me had side effects, I stopped all of them! It’s an awful disease isn’t it, I was diagnosed after a colonoscopy for having terrible diarrhoea for weeks. I hope you have settled down now. I’m hoping the Budesonide will keep it a bay, do you take this med? I really should be super human having both steroids. Do you have microscopic colitis? Sorry if I’m asking too many questions. I’m not sure the PMR will burn out yet, but one can try to get the prednisolone lower, I may well be back up to 5mg. Best wishes to you and keep well.

[bresbo]

I don't have microscopic colitis. I have regular left side UC - proctitis and sigmoiditis. I had my lansoprazole induced colitis flare at the beginning of 2017. I had only taken about 4 of those pills before the side effects started. So I stopped them immediately. I then had about 3 weeks of really bad diarrhoea which gradually subsided over a period of about another 3 weeks. I didn't take any conventional medication during that time because each GP I saw had a different theory (all of them wrong by the way) as to what was ailing me. Finally when I mentioned colitis and ***zole, one of the GPs twigged that it could be a colitis flare, and put me on mesalazine. When several months later I finally saw a consultant, he said to stay on the mesalazine which I have done. I had a different kind of flare from 2020 into early this year. It subsided with a course of rectal budesonide plus an oral budesonide called Cortiment which targets the lower bowel.

As for your PMR, if you are still getting pain in your joints, do not try to reduce your pred dose whatever the GP says. My partner has PMR. Read the HealthUnlocked PMR pages, they have oodles of excellent advice, most of it contradicting what many GPs and rheumatologists advise. But they're right.

[Yealink in reply to bresbo]

It’s really awful, you take medication as a precaution only to end up with yet another problem. It’s so difficult to explain to GPs and a long time actually getting a diagnosis, for me with PMR it took 5 different GPs to finally find one who immediately knew what my symptoms were, as maybe your partner knows. I’m very pleased you have your colitis under control and hopefully it stays that way for you. There is a wealth of information on the PMR pages and all very helpful and knowledgeable people. It’s been nice sharing our experiences, thank you. Best wishes and stay well.

[Gutfeelings]

Hi,Sorry to hear you have microscopic colitis on top of the pmr. I take budesonide orally for Crohn's and I also have microscopic colitis in the form of collagenous colitis, diverticulitis and functional gut disorder in the background to these but issues. Sometimes it can be tricky to know which one is "playing up" but my team at the hospital have said the budesonide treats both the Crohn's and microscopic colitis. I've actually just been home from hospital a couple of days ago after being admitted to hospital due to dehydration and pain. I think I was underlying myself with budesonide as I have noticed my blood pressure seems to go up at times but I have high blood pressure and am on medication so just need to keep an eye on it. I hope the budesonide helps you, it seems to have fewer side effects as it acts locally in the gut. I have taken it in the past and it has helped.

Hope you feel better soon

[Yealink in reply to Gutfeelings]

Hi, thank you for responding. Oh goodness you do have a number of problems, I’m sure it is difficult for you, I really hope you’re feeling better now. My daughter in law also has crohns quite bad actually, she is having a camera tablet in a couple of weeks and hopefully she’ll get sorted very soon, she has had crohns for around 10 years. Today the consultant changed my medication from Budesonide to Octasa, starting these tomorrow and hope they work well, I think it’s because I’m already taking Prednisolone for PMR! What a performance hey! I seem to have reached a ‘certain’ age and it’s been all downhill 😩 Best wishes to you and stay well

[nuigini]

I can't believe the timeliness of your post for me. I too was recently started on Budesonide only yesterday.

I've had PMR for over 7 years, and still have a journey ahead of me on that front. I've been a member of the PMRGCAuk Group on Health Unlocked for 6 of those years and highly recommend if for the fantastic support and advice it offers.

Back to Microscopic Colitis. Based on my own research and on the advice of both my GP and GI Specialist I have reluctantly agreed to try the medication. Reluctant, only because I hate taking medication. I've been advised that there is no problem taking both prednisone and budesonide, although the pharmacist did advise not to take them at the same time.

Best of luck to both of us!

[Yealink in reply to nuigini]

I too don’t like taking meds! I have taken Budesonide for 6 weeks now along with Prednisolone and I’ve not had any problems at all. Budesonide seems to be working for the microscopic colitis, it’s taken a good few weeks to kick in, and this week has been the best so far, definitely reduced the number of times for the loo, which was around 10 times a day, I finally have my life back as we couldn’t arrange anything at all away from home, I’m just pleased I’m still working from home!! My consultant did say 7 out of 10 get better which is good odds and I really hope you and I are one of the 7!! There is a website called GutsUK which was quite helpful and on there is a link to the British Society of Gastroenterology with a little video at the bottom of the page from a Professor Chris Probert about the long term treatment of microscopic colitis, it’s very informative. When first diagnosed with PMR my GP prescribed Lansoprazole which is one of the meds that COULD cause MC and is mentioned on the video. I stopped everything when I first started with bowel problems apart from Prednisolone of course. I no longer take anything other than this and Budesonide, although my GP did want to prescribe something to protect my stomach and I refused. I wish you well and I’m sure Budesonide will work (for me too!!) x