Unable to take Pred due to severe bout of D & V.

[hwigston]

For the past 4 days I have been suffering from a severe bout of D & V. What bothers me is that as soon as I take my medication (Pred) I lose it one way or another. GP seems unconcerned and said there is no medication to help the condition only rest and don't become dehydrated. My worry is that the Pred is not staying in my system long enough to do any good and that I will end up with a 'flare up'. Any thoughts please?

[Celtic PMRGCAuk volunteer]

Oh dear, poor you. If you are not retaining your Pred, then I'm surprised that your GP hasn't recommended injections to tide you over until the D&V subsides. Can you contact your rheumy for his opinion? Yes, lots of water. Also, when I picked up a hospital infection during a visit to my Mum, one of the nurses on the ward recommended sports drinks to help with the diarrhea (they help balance the body's electrolytes), and arrowroot biscuits can help with the nausea/sickness. I do hope you feel better soon.

[hwigston in reply to Celtic]

I managed to take my Pred last night and so far it has stayed there. I had to cancel rheumy, which unfortunately was yesterday. Can't see him now until August. Thanks for advice on energy drinks. I'll give them a try.

[PMRpro Ambassador]

If you have been on highish dose for longer than a couple of weeks then problems related to the lack of corticosteroid is also a possibility and far more concerning. If you're on ordinary pred and it stays in your stomach for an hour you are probably OK - but watch out for feeling very weak and tired (worse than just the D&V). Google "adrenal crisis" for more information about symptoms and go to A&E if you are really poorly, don't mess about unless your GP will come straight out on a house visit. Just in case - it may never happen.

[hwigston]

Hi PMRpro. I have been on Pred for just over 4 years. I was also concerned about adrenal crisis hence the reason why I contacted GP. For 2 days I was extremely weak and exhausted but I put that down to the D & V. I took my pred last night and so far it has stayed there. However, I am not sure whether the D & V, more D than V, is caused by an infection or the Gabapentin which I have been taking for a week for MAV. I have stopped taking it for a day or two until I feel better. Side effects include being sick, nausea and diarrhoea. You mentioned A & E, unfortunately if you have D & V, or think you may have it, you have to stay away. Many thanks for your reply. It's great to know that there is always help and advice on this wonderful forum.

[jinasc]

Try this old fashioned cure for D&V.

Small measure of brandy, small measure of port, mix together, swallow. Repeat after 4 hours. D&V should disappear.

I have used this for years, especially when travelling abroad.

Also, currently what dose of pred are you on and for how long have you been on it?

[hwigston in reply to jinasc]

Wow that sounds awesome, but I think I'll give it a go. I'm on 8 mg reducing to 7 mg. Been on Pred 4 years.

[honeyadams]

There is sulfasalazine, if you can take sulfa drugs, but it takes 60 days to get up to full strength in your body. It keeps the inflamation down like pred does. Pred works within 3 days to reduce the muscle pain. You might want to talk to your doctor about this. My rheumy started with pred and has slowly transferred me to sulfasalazine. Just a thought. Some people cannot take sulfa drugs.

[polkadotcom]

Interesting, Honeyadams, I've never heard of sulfa being used for PMR before and it isn't used a great deal here for other rheumatic conditions. I doubt if any GP would consider using it as an alternative to Pred as it not only takes such a long time to reach full strength treatment but also the side effects are apparently worse in the short term. Did you have any problems?