Pred and pancreatitis

[LemonZest11]

A friend whose mother has PMR has just contacted me to ask me about prednisolone and whether it can be a cause of pancreatitis. I have no idea. Her mother has just been diagnosed with it, and the doctor thinks it was caused by pred and wants to reduce her dose. I don’t know what to say/how to respond, so I am asking the experts here. Thanks for any wisdom.

[Chris_1236]

Before gallbladder removal many years ago, I had regular bouts of pancreatitis. I haven't had any since including the 2+ years I've been on Pred.

But that's just my subjective experience, FWIW. I'm not a doctor.

[LemonZest11 in reply to Chris_1236]

Thank you, that’s good to hear. And it is useful information to pass on to my friend.

[DorsetLady PMRGCAuk volunteer]

There does seem to be a bit online about it -this is just one article -ncbi.nlm.nih.gov/pmc/articl...

But they do seem to infer that patients may have had pancreatic issues before going on steroids, so not all steroids fault. ..but most state steroids need to be reduced -not so easy to do.

Maybe have a search

[LemonZest11 in reply to DorsetLady]

Thank you, very helpful. I will pass this on and also keep looking myself.

[MrsNails]

Hi Lemonzest

This is a very tricky situation for you - we none of us are Trained Medics but Expert Patients……

I’m sure your friend is very worried, does her Mother having any other underlying conditions that may be impacting on her health……

I’m afraid l cannot offer you any advice other than to refer your friend to her Mothers Doctor.

Kind Regards

MrsN

[LemonZest11 in reply to MrsNails]

Thanks MrsNails, all input is gratefully received. Only making enquiries, of course it will be up to her doctor, but they always seem so anti-pred that it is easy to blame. I’m getting some useful info from the group already. xx

[MrsNails in reply to LemonZest11]

I’m always more cautious when it’s ‘the Mother of a Friend’ etc - l know we all like to help when/where we can but l always advise caution You can have a Google (Reputable Sites only) & offer your friend a link to them as that information is there for anyone to see.

That’s not me being unhelpful but we really can only speak from experience or gained knowledge & none of us are Medics.

It’s a tough call - believe me l know! My allergic son (nearly 40years old) runs everything past me on the Medical Front to see if l think it’s OK - Bless Him 💙

Unfortunately he currently has an issue way out of my realm of experience to do with his spine & leg so we must be guided by the Medics……

Hope you’re doing OK

MrsN

[LemonZest11 in reply to MrsNails]

I hear you. And thanks.

[PMRpro Ambassador]

How long has she been on pred? And what sort of doses? Is it for PMR or something else?

The article DL links specifies high dose and developing pancreatitis within a couple of weeks of exposure to the pred. Just because someone is on pred and develops pancreatitis doesn't mean it caused it - correlation is NOT causation!

And of course the dose and duration are also relevant to whether/how far she can reduce the dose. Never mind the PMR ...

[LemonZest11 in reply to PMRpro]

Yes. I have been through the problems of a fast taper and the impact on adrenals. I have asked if she is on a higher dose, 15mgs+ or down below 10mgs. I explained the implications of a fast taper below 10mgs. I think her mother has been diagnosed for around 18 months. Your comments about the connection between pred and pancreas are helpful and pretty much confirms my advice to her to do her own research beyond doctor opinion. I just had a gut feeling that an ER doctor playing pred might be the usual story we tend to hear. Anyway, thanks again. Will pass on all comments.

[PMRpro Ambassador in reply to LemonZest11]

If she has PMR and been on pred for 18 months that really doesn't suggest to me that pred CAUSED the pancreatitis. It may not HELP it - but she can only reduce slowly unless she is under the care of an endocrinologist because she will have secondary adrenal insufficiency due to long term use of pred. So whatever else - she must get proper specialist care for it.

[LemonZest11 in reply to PMRpro]

Yes, makes perfect sense to me. Much appreciated.

[LemonZest11]

Thank you Dad2Cue. It seems pred gets the blame for everything. My concern is the doctor's immediate response to reduce, and we know what that can do 🙈.

[SheffieldJane]

My guess is that Pred could have been the factor that tipped her over into Pancreatitis with other elements having contributed along the way. I now experience Pred as quite caustic and I have to watch what I eat, alcohol is completely out sadly. My GP casually mentioned that I have diverticula disease on Thursday. WHAT! First I’d heard. I avoided PPIs possibly wrongly, I relied on yoghurt. However, like your friend’s mum, the predisposition will have been there, I guess.

[PMRpro Ambassador in reply to SheffieldJane]

People do develop it at our age - pred or not! Like cataracts - I'm finally developing them but at nearly 70 it is hardly surprising ...

[SheffieldJane in reply to PMRpro]

I was never told, unless “a bit of diverticulosis that is normal for your age” following the colonoscopy, is the same as “ diverticula disease”. It all adds to the falling apart feeling. 🤬PS I will rise! 🌈

[PMRpro Ambassador in reply to SheffieldJane]

nhs.uk/conditions/diverticu....

[SheffieldJane in reply to PMRpro]

Thanks for taking the trouble to send this. Doesn’t completely fit the symptoms and I have not been offered any treatment even though I have been in varying degrees of pain for about 4 months.

[SheffieldJane in reply to SheffieldJane]

I remember we both felt that the cataract operation was going to be a positive thing and almost looked forward to it for the end result. I still do. I’ve got a slow growing little bit of one that we are watching, my optician and I.We were a bit cheated out of our last bit of middle age. Perhaps we can make up for it with a brief but vivid renaissance now?

[SheffieldJane]

I get what you mean. Everyone I know seems to have something, I would swop with none of them. I seem to be battling the effects of treatments and how the diseases have left me - weak, tired, lacking in Cortisol function. etc.and I find that the solutions I come up with ( with the help of the forum) are empowering.

[LemonZest11]

Thanks to everyone for input that I will pass on. Yes, it seems that the gradual "falling apart" of our bodies is inevitable as we get older and it can be easy to blame things on pred, albeit it can be a bit of a culprit. Take care everyone, and battle on ... life is still worth the challenges most of us are juggling.

[Bleakley1]

I have had pancreatitis due to gall bladder problems too. Since gall bladder removed all ok but what I do have is gastritis from time to time which can be as painful as pancreatitis. I have recently had an Endoscopy after having a painful bout of gastritis. Although many other issues can contribute to gastritis according to my consultant the steroids do not help. Endoscopy was clear apart from some underlying red areas of gastritis which were not causing any bother.I am reducing pred as we all are but need to take them for the PMR. So what helps one condition doesn’t help another!

[Longtimer in reply to Bleakley1]

Same here..had so much stomach pain, had Endoscopy couple of years ago....they found "sludge"....whatever that is!.....I'm quite restricted in what I can eat....and very small portions....so bloated!.....definitely can't have lactose either......gaviscon is my friend!.....Reducing pre d too......but that has it's problems also......what a minefield.....it's the extras we get that I think can be the most challenging!....

[Bleakley1 in reply to Longtimer]

Know what you mean about Gaviscon. My friend too😀

[Longtimer in reply to Longtimer]

Pharmacist in Boots told me to buy their make of Gaviscon, exactly same contents.....half the price, like many things.....

[PMRpro Ambassador in reply to Longtimer]

Makes a change - Boots own label antibistamine was the same price as the top brand! And their acycolvir cream was too!

[Longtimer in reply to PMRpro]

Well that was a couple of months ago, it may well be same price now....my sister went to her local Boots yesterday, thought they had brought back old covid rules....only one person allowed into chemist at a time...it seems they are struggling to get pharmacists.....

[PMRpro Ambassador in reply to Longtimer]

Tell you - I'm staying here! There are shortages here too but not that bad! My grandson is doing pharmacy and seems to enjoy community pharmacy work - won't be out of a job then!

[Longtimer in reply to PMRpro]

My pharmacy is tucked away at the back of a Waitrose, easy parking etc, but over the last two years have not seen the same pharmacist twice. Two local chemists two streets away closed up, so have no choice...but I contact online repeat prescription, and that should be ready by 4 days......they usually text me two weeks later!....so I make sure I always have plenty of pred!.....there is a shortage of everyone in all trades now it seems!.....but why?

[PMRpro Ambassador in reply to Longtimer]

Lots of them came home!!! And then a lot of the last of the boomer generation have retired in the last few years. It isn't as if they didn't have 50+ years of warning that our generation would all be retiring about now and turning into the patients needin the nurses, doctors, pharmacists and carers ...

[Longtimer in reply to PMRpro]

Yes, quite right....but there are a certain amount of people that could be made to work....I won't elaborate!....it makes it harder for those that are working too.....

[Tanner145]

In Pred package informationNot sure if any help but interesting

Typed instructions

[LemonZest11 in reply to Tanner145]

Thanks Tanner145, I hadn’t seen this before. Will pass that on. All bits of information help to form the picture.