Managing IBS and PMR

[Karenjaninaz]

It seems my lifelong IBS is worse than usual. Any tips from fellow sufferers? Do you up prednisone during an attack? The endocrinologist suggested upping prednisone when feeling unwell.

[piglette]

If it is the IBS that is causing the discomfort taking more pred is unlikely to help.

‘“A study was conducted that examined the use of prednisolone, a corticosteroid medication that helps control inflammation, in treating IBS. However, no significant reduction in IBS symptoms was found in people who took prednisolone”

[Karenjaninaz in reply to piglette]

Im not taking it for the IBS pain per se; I get good help from ginger tea. I feel extremely unwell during it and worry about the IBS stress.

[piglette in reply to Karenjaninaz]

As I understand it you are saying you are feeling extremely unwell and stressed from the IBS?? Have you asked your doctor for any advice?

[Karenjaninaz in reply to piglette]

Last night I ate a delicious helping of spicy chili; normally I like spicy food but I think this time it turned in me. I have regular exams. My gastro, as good as he is, never really talked about IBS other than they can see the spasticity with the colonoscopy. I’ve had multiple abdominal surgeries for other reasons..

I am a retired nurse anesthetist and realize it’s mainly self care. However with tapering and adrenal insufficiency I was wondering if anyone else had increasing issues with IBS.

[Karenjaninaz in reply to piglette]

We need differentiate between irritable bowel syndrome IBS and inflammatory bowel disease IBD. The latter can be autoimmune; the former is functional- our “wiring”. On colonoscopy one can see the intestine clamp down in a spasm as the doctor is trying to pass his instrument. I have seen this and this is my case. There were times when I had extreme abdominal pain from emotional upset. I was in so much pain once that I couldn’t drive my car and asked to go to the hospital in an ambulance. They took a CAT scan; all they saw was a cramped intestine. The standard treatment is emotional support and avoid food triggers to these spasms. These can vary from person to person.

[piglette in reply to Karenjaninaz]

I am sorry I am getting muddled. I thought you were asking whether you should increase your pred dose??

[Karenjaninaz in reply to piglette]

I just was wondering about other PMR sufferers with IBS and what they did with an IBS flare regarding prednisone. My endocrinologist suggested doubling the pred dose during an illness. I did not mean upping the taper program dose. I actually took an extra 5mgm one time only on the day I felt terrible. I think it helped my general feeling.

[PMRpro Ambassador in reply to Karenjaninaz]

I assume he said it on the basis of Sick Day Rules?

healthunlocked.com/pmrgcauk...

[Karenjaninaz in reply to PMRpro]

I’m in the US.

[PMRpro Ambassador in reply to Karenjaninaz]

Sick Day Rules in adrenal insufficiency apply all over the world - the illness doesn't change.

[piglette in reply to Karenjaninaz]

If you read the attachment on PMRPro’s post it explains what Sick Day Rules are. ie double the dose for a short time if you are ill enough to have to stay in bed.

[Karenjaninaz in reply to piglette]

Oh; that’s the same advice I got then. We just don’t call it the “Sick Day Rule”.

I was in such spasm I stayed on my daybed. Does a daybed count?— haha

[piglette in reply to Karenjaninaz]

There is probably a thin grey line between a day bed and actually collapsing onto your normal bed and not wanting to move.

[PMRpro Ambassador in reply to Karenjaninaz]

I called it sick day rules because that is the title of the post ...

[Sangu1 in reply to Karenjaninaz]

Have you thought about trying Buscopan? It’s used for IBS, and you can buy Over the counter. Usually one to two tablets three times a day. Check with your pharmacist for any interactions with current meds. I hope that helps.

[Karenjaninaz in reply to Sangu1]

Sangu1,

Buscopan (scopolamine) has been banned in the US otc because a certain number of users had a cancer like markers in their blood. I am familiar with the drug in my anesthesia practice. It is used to dry the mouth and prevent post operative nausea.

It is also used transdermally behind the ear for motion sickness prophylacticly.

I personally did not like using it because patients woke up in delirium.

It is indeed an antispasmotic but at my age I cannot afford confusion.

Peppermint tea and ginger tea work well. With this severe attack I didn’t have the peppermint tea on hand- until hubby was dispensed to the store.

[Sangu1 in reply to Karenjaninaz]

Sorry, I did not realise you’re from the US. Great with peppermint. Mebevrine also an option but probably rx only as well. Glad you’re getting better with your IBS.

[arvine in reply to Karenjaninaz]

so I have been diagnosed with IBS since my 30s, Im now 73, I would have sudden onsets of diarrhea, through the years, that changed this past DEC, to where I was having problems with cramping, pressure, and passing hard bits of stool, saw my GP, he did ultrasounds, told me to start taking metamucil daily, said, only showed spasms in ultrasound, then sent me for catscan, same verdict, so I didn,t understand why the change in my bowel habits, except I said, I had tried to taper from 5 mgs of pred, to 4 back starting in Nov, and did the dead slow taper, seemed I had been doing ok at 5 , bloodwork at that time was ok, had been on 5 for many mos. at any rate, still am having that issue, but somewhat better with metamucil, although have to move bowels several times a day, like from 4 to 6 times, so the end all conclusion from my GP was, just "spasms" ?? so what is the difference then from IBS and inflammatory bowel disease, ?

[Karenjaninaz in reply to arvine]

Inflammatory bowel disease can be autoimmune in nature while IBS - used to be called spastic colon- means just that. The bowel is “wired” such that it spasms more easily from various triggers, including emotional issues. With inflammatory bowel disease (IBD) the bowel is inflamed while with IBS no inflammation is found - just a bowel in “knots”.

There is a website called help for ibs with helpful suggestions to manage it.

[jaycee444]

Hi, I suffer from both PMR and Ulcerative Colitis.. I did find that being on Prednisolone for my PMR did lessen the problem with Colitis somewhat. I did however have a flare up of my Colitis last year during lockdown but brought it back under control by increasing my Pentasa (Ulcerative Colitis medication) rather than a Pred increase.

[Chewy21]

I have IBS and I cannot eat anything spicy, if I did I would be in agony for days. Since eliminating spicy foods it has been much better. I don't eat anything that has garlic in or peppers of any kind either, tomatoes can also set mine off so I try to avoid them too.