Prednisolone and low stomach pains

[villalatina]

Because of a vasculitis flare up I recommenced prednisolone 15mg this morning with my breakfast of porridge and blueberries. Within 2 hours I git severe stomach pains- very low down - which hasn't gone away. I spoke to my GP a short while ago and have been advised to stop them and have an appointment on Monday morning to see him. Since having Covid last year I seem intolerant to most medication including antibiotics, which is a bit worrying. I'm not due to see my rheumatologist until October- ho hum!!

[SnazzyD]

Hello, when you say low down do you mean low down the abdomen or the stomach itself? I ask because people often call the whole frontage the stomach.

[PMRpro Ambassador in reply to SnazzyD]

I asked that in the first thread - very low down they said.

"Yes very low down. I do also have diverticulitis and gastritis- not much hope for me really!!"

[PMRpro Ambassador]

Be interesting to see if it improves - but the tablets wouldn't have got to that low down in the gut in 2 hours, just past the stomach at most.

[villalatina in reply to PMRpro]

That's very interesting. Perhaps it's diverticulitis.

[DorsetLady PMRGCAuk volunteer]

Let’s hope he comes up with a solution on Monday - maybe adding in a PPI like Omeprazole or similar if you aren’t already on them….

Are you taking any other medication at the moment?

[villalatina in reply to DorsetLady]

I'm already on omeprazole. Perhaps it's just a diverticulitis flare up- who knows. We have a truly wonderful doctors practice (we are really blessed) so hopefully a solution can be found.

[Blearyeyed]

Had you been on Pred for some time before the dose was increased to 15mg or had you just started taking steroids?I ask because if you had just increased the dose and been on steroids for a while I'm surprised that the GP would have just told you to stop the Pred altogether " cold turkey" unless you had only been taking Pred for a few weeks as doing that could cause it's own problems .

If you had been on steroids for some time the GP should have advised you to go back on the dose you were taking before the flare , checked that you were taking your PPI to protect the stomach and arranged for you to be seen as an emergency by a gastro at the hospital to scan your stomach and make sure you had no gastric bleed , ulcers or other inflammation.

If you have only just started Pred you could stop without the side effects but the GP should still have taken blood tests , examined you and arranged for a scan appointment to check whether that was your usual diverticulitis or another cause that requires immediate attention.

Do you also suffer from IBS as well as your diverticulitis ?

It is possible that either condition could have flared up in reaction to starting a new drug , like steroids , or to a large increase in your Pred dose and the pain would continue until your body had adjusted.

The type of food may not have contributed in anyway , especially if that is your usual breakfast.

This possibility also needs proper care and investigation.

I would personally keep a close eye on your symptoms , not just gastric ones , over the weekend, and if you feel any worse I'd arrange to go in for an out of hours appointment at the hospital or AandE to be sure that whatever is happening is looked at as soon as possible.

Drink plenty of fluids and eat lighter smaller meals of the bland foods your stomach is more able to tolerate when you have your usual diverticulitis or gastric symptoms.

Get plenty of rest until you are seen , and raise your head and shoulders in bed in case the symptoms are related to stomach acids or acid reflux.

I would definitely be requesting blood tests for inflammation markers and a full blood count and to be sent for an urgent scan when you see the GP if that doctor doesn't automatically suggest these themself .

Even if they examine you and believe it is your usual illness flaring up.

They shouldn't dismiss other problems unless they've been properly ruled out by investigation .

You need to know if this was caused by the Pred or not, as you need to treat your vasculitis , and need to know if you can still take Pred , or, must use another drug option instead to control your inflammation.

Take care and don't wait until Monday if things get worse , Bee

[villalatina in reply to Blearyeyed]

Thank you so much for your very informative reply. I've been off steroids for some months and resumed only yesterday. I'm seeing my GP again on Monday morning. I'd only taken one dose of 15mg hence was able to stop. I have every faith in my GP practice and am seeing a senior partner who knows me well.