I have had to increase from 6mg to 15mg for GCA flare. Minor stomach grumbles have now increased into some pain. I have some enteric pred to try. I believe it slips through the stomach and dissolves lower in the gastrinal tract with less acid? I am worried that this might have an impact on bladder. I have a long term condition called interstitial cystitis which is basically an inflamed bladder so it is very vulnerable to irritation. (It did not like omeprazole.) Has been fine on ordinary pred.
Does anyone know anything about or experienced bladder problems with enteric pred, please?
Also, I would prefer to keep on with ordinary pred if I can because I want to stabilise the flare - I've heard enteric reacts less quickly? Any thoughts on this.
Many thanks in advance for your help. X
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Viveka
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Why would it affect the bladder any more than any other pred? It is absorbed in the duodenum mostly and then goes into the bloodstream from there. It is then excreted via the kidneys in exacly the same way as ordinary pred.
Great, thank you so much for your knowledge yet again.
I had this idea that if it hung around for hours being absorbed through in lower gastrinal, any liquid I took in would wash down into bladder. It takes very little to set things off and I have been housebound on several occasions but I think I need to give it a go!
There is no natural direct connection between the GI tract and the renal system, everything has to travel via the blood stream. The link with gut bacteria leading to bladder infections is via the external route - why we are always told to wipe from front to back after going to the toilet to minimise getting bacteria from stool being transfered to the urethral area and then travelling up to the bladder.
The follow up question I wanted to ask was is it ok to mix coated and uncoated as a trial? I thought I would try 5mg enteric and then if ok gradually swop from uncoated to them.
(Intersitital cystitis isn't bacterial infection - it's tiny ulcers permanently on the bladder wall. I am generally not too bad, just have to avoid things that upset it - main one is alcohol or citrus fruit juice on an empty stomach. Coffee and tea are ok in moderation. Travelling sets it off, so I dont much.)
Yes - I know what i/c is. I also had the same problem as Snazzy mentions with calcium carbonate supplements - just in case that is relevant to you.
The problem with mixing e/c and plain pred is the time they take to be absorbed and the resultant level of the peak achieved in the bloodstream. e/c can take anything from 4 to considerably more hours to get to the highest level because they aren't absorbed directly from the stomach and the amount of food and your personal gastric motility is relevant. Plain pred are absorbed directly from the stomach, so within an hour achieving a sharp high spike which then falls. e/c climbs slowly to a lower more rounded peak that lasts longer as it rises and then falls off.
How fascinating. I will probably move to enteric when/if flare stablises for a week or so on this dose. I don't feel any difference before pred to after pred so probably ok for slower build up. Thank you.
I used enteric coated Pred because it was the only way I could manage the gastric symptoms. All I did was assume the peak level occurred 4 -5 hours later instead of 1-2 hours later like uncoated. As PMRPro says, that is nothing to do with the effect on the bladder directly. At higher levels Pred gave me cystitis and I had to drink lots of water. I also, discovered by process of elimination that calcium supplements also gave me burning urine and indigestion. I had to halve the dose and certainly couldn’t take the calcium/vitD the doc prescribed.
When I was on a high dose pred for GCA I developed really severe bladder inflammation, very painful, never having had problems before. Even now, 5 years later, I have mild problems particularly after taking my AdCal tablets, coffee & alcohol also irritate. I have always been on enteric coated pred.
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