Can D&V be a symptom of steroid withdrawal?

[Sharitone]

Cannot find a definitive answer to this- have been instructed to reduce pred fairly quickly, 2 weeks each on 17.5mg, 15mg, and 12.5 mg. Now just on to 12.5mg. Was hit in the middle of the night by D&V, though I don't think I have been in contact with anyone else with it, or eaten anything dodgy. So could it be part of withdrawal process? I would sneakily reduce more slowly, but have to get to 10mg in time for a blood test, so I would get found out. Also have developed some spinal compression fractures.

[Kendrew]

Hi Sharitone. My understanding is that suddenly stopping steroids after being on them for more than a very short period of time, or too rapid a dose reduction may in a few instances cause d&v. However I feel it's far more likely you've picked up a stomach bug or eaten something that's disagreed with you. Many factors may need to be considered before knowing for sure but as with any case of d&v, certain protocols should be followed. Stay hydrated and drink only water initially.....starting with sips and building up gradually to more. When you can keep water down, try small amounts of solids such as bland foods like dry toast, plain biscuits, etc. If d&v continues for more than 24hrs, seek medical advice, and if you see blood in vomit or diahorrea, also seek medical advice. Just see how things go and hopefully it'll settle down.

Also bear in mind that you may not be absorbing as much (if any) of your pred if you're vomiting it up or passing it through your bowel too quickly. This will definitely need advice and possible intervention from a medical professional.

Others with more knowledge will be along to advise as well on other matters you mentioned too.

[Sharitone in reply to Kendrew]

Thanks for your help, Kendrew. I guess it's easier to pick up any little old bug when one's immune system is on its holidays!

[Kendrew in reply to Sharitone]

Absolutely.

[SnazzyD in reply to Sharitone]

It doesn’t take much if you are susceptible and if you are also taking stomach acid lowering drugs, you are at even more risk. It’s not always the usual suspects either; you can get a nasty one from rice and pasta.

[Sharitone in reply to SnazzyD]

Oh yes. 40mg Omeprazole, so that it explains it, too. I never used to get stomach upsets.T hanks for the info!

[Purplegloss in reply to Kendrew]

Not on Adcal are you, as that is what happened to me whilst taking it. Fine once I stopped using it though, which was a relief to say the least.

[Sharitone in reply to Purplegloss]

No, just accrete and denosumab. but now I know to steer clear of Adcal - thanks!

[PMRpro Ambassador]

It would be unusual at that dose - it is a sign of adrenal problems and at 12.5mg that shouldn't apply yet. And yes - it COULD be the omeprazole - either because the lack of acid has allowed a bug OR it can be an adverse effect with some PPIs and it doesn't always start immediately.

[Sharitone in reply to PMRpro]

Thank you. Who needs private health care with you around?🙂