Erosive Gastritis Anyone - Prednisolone - PMRGCAuk

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Erosive Gastritis Anyone - Prednisolone

Songbird69 profile image
25 Replies

Hello!

Wonder if my trusty friends can help?

I have been suffering with intolerable wind, bloating and diarrhoea for well over a year, with my gastroenterologist fobbing me off at every turn. Now, as an aside from an upper endoscopy for different reasons, I have now been diagnosed with erosive gastritis. I can’t help thinking that if anyone had bothered to investigate before, it may not have got to this point.

It is believed by the endoscopist that this is a result of the Prednisolone I have been taking for GCA/PMR. Yet, I have been taking Gastro Coated Pred for 5 years, and have tapered to 2mg, which I have been on for months now. I always take it with food.

I don’t buy that this is the cause but does anyone agree that this could be the reason why I have this?

If anyone has suffered with this, what did you do to sort it?

🥰

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Songbird69 profile image
Songbird69
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25 Replies
piglette profile image
piglette

I have never had gastric problem with enteric coated steroids. I think you may be being fobbed off.

Songbird69 profile image
Songbird69 in reply to piglette

That’s what I thought. It all started after months of antibiotic use and the beginning of a biologic for Crohns. Mild at first, but worsening over the year to where it is today.

🥲

piglette profile image
piglette in reply to Songbird69

Hope you get it sorted out.

PMRpro profile image
PMRproAmbassador

There is a theory that it isn't the presence of the pred in the stomach that causes the problem but high systemic levels that have an effect on the stomach.

Are you also taking a PPI of some sort?

Songbird69 profile image
Songbird69 in reply to PMRpro

Hi Pro,

Good to hear from you. Maybe they are right then! I tend to believe you over the docs these days. 🙂

I had taken a PPI off and on over the years but tried not to. For several months until this was diagnosed I was taking 10mg as the side effect of constipation was helpful with the diarrhoea!

I was put on 40mg omeprazole morning and night, but after 4 weeks it seemed to be making everything worse, so I have been switched, only a few days ago, to Famotidine, but too early to see any difference.

I told the Gastro in June that my pain was intolerable and stopped me from sleeping and he subsequently wrote to my GP to say I had mild abdominal discomfort!

Big sigh!!

PMRpro profile image
PMRproAmbassador in reply to Songbird69

A PPI can cause all sorts of problems - though I'd have thought it would take longer than that. Not what you'd expect ...

ncbi.nlm.nih.gov/pmc/articl...

Songbird69 profile image
Songbird69 in reply to PMRpro

Thank you. I knew PPIs could cause abdominal issues, but didn’t realise they could cause gastritis. 🙄

I tried not to take PPIs as much as possible, although the GP was insisting I should be taking them the entire time I was on steroids, but I didn’t feel the need, and kept off them as much as I could. I didn’t have H Pylori - if I had, it might have explained things.

Just hope they will look beyond the steroids for answers.

Telian profile image
Telian in reply to Songbird69

I’ve been on Prednisolone since 2014 plus Omeprazole. After 6 years on the latter I developed a painful stomach with bowel changes. My GP changed the Omeprazole to Lansoprazole which I still take. Some time later I was sent to A&E with heart attack symptoms that turned out to be severe gastritis. I had an Endoscopy to be told what they found wasn’t quite an ulcer but confirmed the severe gastritis for which they gave me Famotidine and Gaviscon 4 x daily. The Famotidine works a treat and I can’t be without it, I was so ignorant at the time about Omeprazole - something supposed to protect the stomach eh!!!! Now I can’t eat a full meal, I graze throughout the day. No spicy foods and I eat gluten free not strictly but it helps. I also sleep on my left side. See Bee’s comments. There’s far more to it than I’ve told you but it’s my outline.

Songbird69 profile image
Songbird69 in reply to Telian

Gosh! You sound like me. I was ambulanced to hospital a few days ago with heart attack symptoms but they didn’t connect with gastritis. No heart attack anyway - phew!

The Famotidine seems to be working but still have many bouts of diarrhoea. Can’t put on any weight - and I need to.

Trying gluten free to see if that helps and already lacto free.

Thank you for sharing.

Calliope22 profile image
Calliope22 in reply to Songbird69

All my gastro problems stopped within days when I stopped taking a ppi(thanks to this forum!). I also changed the calcium supplement that I take, going back to one that suited me before a gp(who had never seen me or even met me!)insisted that I take her prescribed one. I have had NO support from my gp and rely on this forum whilst managing my current (first) flare and have learned some patience in so doing! Good luck

Blearyeyed profile image
Blearyeyed

It can be a combination of factors , and if you have a weaker digestive system or stomach and oesophagus lining for other reasons then the steroids are more likely to cause the gastric side effects they can cause even with precautions. If you have Crohn's it is also a common condition linked to that.Have you also been diagnosed with any other conditions in their searches like IBS , gastric reflux / GERD?

It sounds as though you may be one of the people whom would benefit from a PPI or famotidine ,because you have other chronic health issues that warrant it's use ( I know some people with UC , Crohn's and coeliac whom needed both PPI and famotidine as well as a Antihistamine to calm down the various symptoms) as well as taking enteric coated medication with stomach protecting foods like yoghurt.

It can take some months for the PPI to feel like it takes effect . It's also possible to take the PPI just while you are getting the gastritis or other acid issues back in control and damage is healed then wean yourself back off them to use natural products except for times when flares occur.

If you have erosive gastritis have they given you any other Self Care tips to reduce the symptoms or damage , not just the added care in taking certain medications?

Sleeping with your head and shoulders raised on angled , supportive pillows helps to reduce the movement of acid into the oesophagus and causing more damage . If you need to sleep on your side , sleeping on the left also helps this as on your right your stomach is higher than the throat and the acid can trickle into the oesophagus.

Eating less acidic and sugary foods and artificial sweeteners and ingredients also helps give the body chance to heal . Alcohol and smoking or vaping is also best avoided. Probiotics can help rebalance the gut and also reduce the diarrhea and IBS like symptoms you are having. Drinking more cool water through the day , especially during activity and while eating also helps reduce the effects of stomach acid . Simple smaller portion meals containing soluble fibre, 5 times a day rather than three big ones , can make digestion in the small intestine easier and help you absorb more nutrients if your food is passing through the intestines too quickly.

Trying a few spoons of probiotic live yoghurt , either with a little honey , or non spicy flavourings like herbs , garlic , tomato etc to use as a dip for crudités before a meal can also settle the acid before eating.

Has any body discussed Fungal infection with you , I have found over the years with my digestive problems that I have often had fungal overgrowth in the oesophagus and small intestine ( symptoms similar to S.I.B.O) . Now , I generally need a course of antifungals after a few courses of antibiotics to reduce the burning symptoms and bloating. It's just worth considering. I usually also need to go fungus and yeast free in my diet for a month or two after antibiotics to reduce the inflammation and scratchy irritation in my stomach and oesophagus.

If you aren't on the Crohn's , Coeliac or IBS forums it might be worth taking a look and writing a post as they will have already had experience of this type of gastritis and lower GI symptoms and will have other patient experience tips , or medication suggestions that you may not know about which could help you too. Take care ,,Bee

Songbird69 profile image
Songbird69 in reply to Blearyeyed

Thank you for taking the time to write this post.

As it happens, because I have had all these symptoms for so long, and worsening, and basically being fobbed off by my IBD team, I resorted to paying money which I could ill afford for a GI stool test. Several things came out of it, but I had high Candida so currently on a short course of Fluconozole - almost finished but haven’t noticed a difference. I am aware that Candida can cause erosive gastritis and thought that might be my answer.

I realise that this isn’t really the forum to discuss my intestinal issues(!) but It was the Pred issue that they say is probably the cause and it just didn’t sit right with me.

I actually think my PMR could be in remission but can’t taper any more until I get this issue sorted as I am probably not absorbing the Pred properly - I notice that in my day to day symptoms!

Thank you so much for your input. I really appreciate it. X

Karenjaninaz profile image
Karenjaninaz in reply to Songbird69

I found fluconazole interfered with pred absorption and lowered blood sugar. I felt terrible on it. It was given for thrush.

Blearyeyed profile image
Blearyeyed in reply to Songbird69

It took me a couple of months of courses of the Antifungals to reduce them with the fungi and yeast free diet . It's harder to remove than a bacteria.The Pred as I say will be causing more irritation to the stomach and can be making a weaker stomach and intestinal wall worse although it won't be the only reason.

Still it doesn't mean that you stop taking it unless you can't tolerate it anymore or it is obviously causing more damage or bleeding. Just do all you can to protect your stomach while you take it.

Songbird69 profile image
Songbird69 in reply to Blearyeyed

Thank you. I will look into the anti fungal diet. That’s very interesting.

Blearyeyed profile image
Blearyeyed in reply to Songbird69

It includes not just removing obvious yeast and fungus from the diets but foods that can have a high content of fungi, yeast or mould because of their production , like coffee , grapes , rice, flour, , yeasted breads , fresh fruits without skins , soft and veined cheese , corn , dried fruit , peas, salad vegetables, processed foods containing yeast extracts , it's often used in savoury foods as a natural flavouring . You can , however, continue to eat probiotic live yoghurt.

Songbird69 profile image
Songbird69 in reply to Blearyeyed

Thank you. It’s a minefield as I am already on a Crohns diet which majors on things like rice and rice flour! I need to do some serious research.

Blearyeyed profile image
Blearyeyed in reply to Songbird69

Also forgot peanuts are on the avoid list. I know the loss of rice and flours floored me a bit. I did start using buckwheat from the first fungal free diet and I love that now.It's not actually a wheat . It's used in lots of products, but you need to check they are 100% buckwheat in the ingredients. I use it now often to replace other things. The plain buckwheat can be used instead of pasta , rice or barley in soup. Holland and Barrett do an unsweetened Puffed Buckwheat cereal which is very nice. You can also get pastas , noodles and crackers.

You can also still use polenta or well stored almond flour , it's other fine mill flours that are more likely to contain spores. And it isn't forever . My fungal overgrowth was in control for a few years until my recent need for a number of antibiotics in quick succession .

Songbird69 profile image
Songbird69 in reply to Blearyeyed

Thank you so much. Tell me, did you get tested regularly for Candida? By the GP? Hospital? I didn’t have the normal symptoms so wouldn’t have been aware had I not forked out a heap of money for the private stool test and can’t keep doing that!!

Blearyeyed profile image
Blearyeyed in reply to Songbird69

I had problems for years , and I knew what it was, but it took getting the right GP to get the test done. They just go on other symptoms now and choose to start the fungal therapy after I take a long course of antibiotics.

SnazzyD profile image
SnazzyD

Hello, I do think that sadly docs will tend to look at the offender with previous form and blame that, job done. I’ve had a delicate intestine for years. It was helped hugely by going gluten free and largely dairy free (by accident rather design) but in the couple of years up to GCA I had nightly acid reflux. So when I started Pred my stomach was filled with lava. PPI’s made it a whole lot worse along with causing upset in my pipes further down. Docs didn’t believe it could possibly be that but change me to the Famotidine type. This worked for a few weeks but then I got an amount of acid rebound. Eventually I was able to persuade my GP to give me coated Pred. It took a few weeks for my stomach to heal and it was a game changer but for as long as I was on reasonably high doses of Pred I needed nighttime Gaviscon. I also have a condition where my neutrophils drop every three weeks and this can spark gastric tenderness or reflux for a week. I assume that the wrong gut flora become more numerous and cause temporary issues. If I treat myself to gluten or diary food, I certainly know about it too. As Bleary says there may be something else going on like a fungal or bacterial overgrowth, especially if your immune system is dulled by Pred. I also agree with their suggestion to wander to Crohns etc advice pages to see if any of that resonates. So often we have to be our own detective whilst trying to remain objective and scientific.

Songbird69 profile image
Songbird69 in reply to SnazzyD

I totally agree that we need to be our own detective and take charge. I research and read constantly in an effort to sort myself out but currently losing the will.

I need help from the professionals but guess they are so busy right now, they just want you in and out!

SnazzyD profile image
SnazzyD in reply to Songbird69

oh yes, indeed!

Karenjaninaz profile image
Karenjaninaz in reply to Songbird69

Are you taking VitC by any chance? All forms caused me gastric distress - even buffered forms. It’s an acid ( ascorbic).

Songbird69 profile image
Songbird69 in reply to Karenjaninaz

I used to, but can’t tolerate it at the moment. Can’t even take my liquid iron supplements as mixed with apple juice and too acidic.

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