Abdominal pain

[Patience47]

I have cereal with banana in the am, but have frequent abdominal pain in the evening. Came down with PMR soon after being diagnosed with two bleeding ulcers. Would like to know what others eat before taking their prednisone. Any comments would be greatly appreciated as I have learned so much from all of you.

[PMRpro Ambassador]

Are you taking your pred twice a day since you mention evening problems. In PMR pred should be taken once a day, in the morning.

[Patience47 in reply to PMRpro]

I take 6.5 mg in the morning. Only one am dose a day.

[PMRpro Ambassador in reply to Patience47]

Have you had the evening abdominal pain investigated?

[Chrob]

I have poached egg as early as I can

[Patience47 in reply to Chrob]

Thanks, will try.

[polkadotcom]

Yoghourt with the banana in the mornings would give a better stomach liner?

[Patience47 in reply to polkadotcom]

Will give it a try.

Appreciate your response.

[SnazzyD]

I'm only in my first week of Pred taking, and have struggled with the burn. I have found it helps to split my meals up into smaller more frequent meals with not too much starchy food in one go. It seems to avoid the empty acidy churning after a big meal has gone and it appears to stop the extreme ups and downs of my sugar levels. So far so good.

Have you been checked for more ulcers recently or related factors like Helicobacter pylori infection (poo sample)? Is your pain with stomach protection or without. More knowledgeable responders might be able to comment more.

[Patience47 in reply to SnazzyD]

No Helicobactor pylori found by gastroenteroligist. However, this was over four years ago. I take Dexilant caps / 60 most twice daily. Don't have stomach pain all the time. When I get below 6 MG of prednisone I have little or no pain.

[Patience47 in reply to SnazzyD]

Will try smaller meals.

Thanks so much

[maria40 in reply to Patience47]

I have a bowl of porage with cinnamon and ginger, take my pred, then have a couple of spoons of plain natural yogurt. I assume you are taking enteric coated prednisolone which would be important for you. I did get some stomach pain before I requested enteric coated but that has stopped now.

[Patience47 in reply to maria40]

No, I don't take enteric coated as I can't split them. Will try your way of eating before prednisone.

Appreciate your response.

[PMRpro Ambassador in reply to Patience47]

There is no real reason why you can't take both enteric coated and plain - many people have done so to be able to adjust their doses. You can take the bulk as enteric coated and just a small amount as plain.

You can get 1mg enteric coated pills now (since last August) and using the Dead Slow approach it is perfectly possible to reduce 1mg at a time. If you are very sensitive, doubling each step will help.

[Patience47 in reply to PMRpro]

I will ask Rheumy to make change in med.

Thanks

[susyj in reply to PMRpro]

This interested me because my GP told me yesterday that only 5mg and 2.5mg were available in enteric coated! I'd asked for 2.5mg and 1mg.

I will tell him!

[PMRpro Ambassador in reply to susyj]

medicines.org.uk/emc/medici...

because he won't believe you!

[susyj in reply to PMRpro]

Haha! I think he will!!

But I've printed this out just in case Thanks x

[PMRpro Ambassador in reply to SnazzyD]

Snazzy: There are gastric experts who believe cutting carbs is also a way of managing reflux - and it is certainly a way of managing your weight while on pred.

[Rimmy in reply to PMRpro]

Hi PMRpro

That's interesting about carbs and reflux. I have noticed since cutting carbs a lot my digestion is better than it has been for years - less gargling and 'windy' - which used to disturb my sleep. I was assuming consuming less sugary stuff was helping with that and it now seems even more likely from what you say. Certainly helping with weight loss - now about 6 kg in 6 weeks and my appetite hasn't (yet) been the 'voracious' one many people warned might be a side effect of pred ! So I thank you for this excellent advice about diet which I adopted at the outset.

Best wishes

Rimmy

[PMRpro Ambassador in reply to Rimmy]

The amount of wheat and sugar that is part of the modern western diet is overwhelming our systems. They are neither of them inherently evil unless you have a wheat allergy (I do) or are coeliac or are diabetic. But the likelihood is that my allergy is due to too much wheat - I can eat some, just not much, and Type 2 diabetes is definitely due to the enormous amount of simple carbs in the diet. Especially HFCS - which encourages insulin resistant cells.

[TooSore]

Yogurt or Cheese is helpful, and waiting before coffee

[karools16]

I had a lot of tummy problems, about a year ago, and cut bananas out. No more tummy aches.

[Patience47 in reply to karools16]

I quit eating bananas for two weeks, but still had abdominal pain.

However, so glad quitting bananas helped you.

Thanks for responding

[Toshiespeaks]

I had six small meals a day, drank over 64 oz of water, low-sodium low-calorie diet (under 1250 calories & under 900 mg of sodium) and was very regimented; In the beginning, I stayed away from citrus in the morning because it made my stomach acidic (I was able to eat citrus within a few days). I took a Prilosac with 12 oz of water 45 minutes before eating breakfast, would eat 3/4 of my breakfast and take the Prednisolone with 8 oz of water, eat the rest of my breakfast, then have 1/2 a banana mid-morning. Yogurt mid-afternoon. The second Prednisolone 3/4 of the way through my dinner with 80z of water. Eat lots of vegetables and fruit. It took 3 full days of this regiment to feel good (or the best I have while taking steroids and fighting GCA/PMR symptoms). I also lost 15 lbs over the first 2 months (was about 10 lbs overweight to start). The low-sodium is very hard to start, but easy once you know what to eat. It made me feel much better and no swelling in face, stomach, or feet. I did this, under the advice & supervision of my doctor, to try to mitigate the steroids potential/additional damage to my kidneys, heart, and eyes. Good luck, that nervous/acid stomach feeling is the worst on top of all the other issues. Make sure you get your doctor's approval before starting Prilosec and starting any diet.

[Patience47 in reply to Toshiespeaks]

Thanks

[Toshiespeaks in reply to Patience47]

Good luck. I know that you will figure out what works for your body. It does take a few days on any diet to see some change. After a week, I was never hungry (in fact felt like I was eating a lot all the time), and felt reasonably good (no headache, little stiffness, but still had a slight buzz of jittery energy from the steroids, urinated more frequently, and slept too little). A lot of people with PMR and/or GCA have additional health issues, which would constrain them to other diets, but there are few illnesses that a low sodium diet does not help. I have since come off the steroids and had blood tests confirming no adverse effects from this diet. So, fortunately, I found what worked for me. Unfortunately, I have been having some stiffness and just started getting that nasty headache again day before yesterday, so back to the doctor for me. I have been eating a regular diet (full of sodium and anything I want -yes - unlimited amounts of pizza, bbq sauce, milk, cheese, salad dressings, etc.) and gained 13 lbs since September, so I may be back on the low-sodium diet again if prescribed Prednisolone again. I just started the 1250 cal a day diet last week to bring my weight back to normal (not sodium restricted). I use the free application myfitnesspal.com (Computer, and smart phone) to monitor my diet, exercise, nutrients, and carbs, fat, protein, and sodium intake. It is easy, you can scan most labels (with your smart phone), or add your own recipes and it calculates the nutritional information.