Tummy troubles...any need to increase pred

[Temoral]

Long awaited holiday, but with IBS rearing it's head ...First bloating, then one bout of diarrhea. Having a day of rest, but should I increase pred from current 3.75, or just wait to see if symptoms subside. No boat trip today as planned Feel! Feel a little headachey and woozy. Any advice gratefully received.

[SnazzyD]

Are you abroad? Do you normally increase your Pred with IBS bouts and does it help? Sick day rules might be in order for adrenal reasons.

Might it be Covid because of the other non-gut symptoms? Both my husband and I had upset tummies with Covid recently.

[Temoral in reply to SnazzyD]

Yes...abroad. Gozo. Half way through the holiday. Usually I just stop everything, which I have done today. Only once did I increase by 1 mg...difficult to say what works amongst all the fatigue etc of a 'normal day'. No Covid here, but I will test...brought some with us. Thanks

[SnazzyD in reply to Temoral]

Presumably you have gone via an airport. Bear in mind it can take a few days to test positive. I hope you can partake in some of the good bits even if you stop everything. Weather has been vile in the UK!

[PMRpro Ambassador]

You wouldn't normally - but I suppose you have to consider it COULD be adrenal insufficiency having an effect, Any stress goes for my lower gut these days and diarrhoea can be a sign of that. I'd try a bit more - if it doesn't make a difference you can go back down.

[Temoral in reply to PMRpro]

Yes...my gut does react to stress too..even when the stress might not be obvious. I have tapered from 5mg really, really slowly in order to try to avoid problems...maybe try 5mg for a couple of days, then revert to 3.75 at home, just to be cautious. Hope I'm not fussing...thank you.

[PMRpro Ambassador in reply to Temoral]

Even the travel is stress - and stress can be something nice too. Your weather looks better than anywhere further north!!!!!

[Temoral in reply to PMRpro]

Yes..stress can be positive and negative. Very grateful for the weather..soon be home to all the rain...hope nobody on here is flooded. Thanks for your replies.

[Alazarin in reply to PMRpro]

what are sick day rules please?

[PMRpro Ambassador in reply to Alazarin]

The guidelines for increasing pred to cover for adrenal insufficiency in illness or injury. It depends on your dose to some extent.

You will find a lot about them in the FAQs - which are useful to know your way around for all sorts of things. They are to be found in alphabetical order here:

healthunlocked.com/pmrgcauk...

Adrenal information is here

healthunlocked.com/pmrgcauk...

and Sick Day Rules in particular here:

healthunlocked.com/pmrgcauk...

This is also an excellent leaflet

endocrinology.org/media/414...

[Alazarin in reply to PMRpro]

Thankyou Pro.

[SheffieldJane]

I have suspected IBS and sick day rules do not help me. Buscopan does sometimes.

[Temoral in reply to SheffieldJane]

Thank you...have you found yogurt helpful?

[SheffieldJane in reply to Temoral]

I haven’t specifically tried yoghurt but counterintuitively eating lightly does sometimes soothe the gnawing pain that might be diverticulitis. One of the GPs thought that IBS was in the mix though. I had take out food the night before last ( rare for me but we were away from home). The pain started an hour or so later and I was very sick. I had chosen the most innocent thing on the menu, it must have been the Teriyaki marinade.

[PMRpro Ambassador in reply to SheffieldJane]

You do know the ingredients in teriyaki marinade don't you?

kikkomanusa.com/foodservice....

You'd have been better with a fish supper!!!!

[SheffieldJane in reply to PMRpro]

The choices were limited near the hotel, chicken breast, white rice the chicken marinaded in Teriyaki sauce, dry, - Japanese Asian Fusion restaurant. I lost it all in any case. The night before we saw Zoe Wanamaker and Derek Jacobi and an Irish actor from the Game of Thrones series, whose face I knew, at a wonderful fish restaurant near the theatre, so the anniversary wasn’t all ruined. Been poleaxed ever since as the “ rest day” was not restful.

[DorsetLady PMRGCAuk volunteer in reply to SheffieldJane]

😔

[SheffieldJane in reply to DorsetLady]

Where’s my pink flower? I saw Derek Jacobi there for Kenneth Branagh’s first night as Lear!

[DorsetLady PMRGCAuk volunteer in reply to SheffieldJane]

I was doing a sad face, because of your IBS, but wouldn’t want you to feel deprived…so you can have two 🌸🌸.

DJ is great….still remember him in I,Claudius on the Beeb years ago…and many different things since…

[SheffieldJane in reply to DorsetLady]

He has real presence, smart as a dart with a shock of thick white hair. I should be so fortunate. Thank you for my flowers. 🤗

[PMRpro Ambassador in reply to SheffieldJane]

We sat next to Sheila Hancock at a restaurant in Notting Hill many years ago. Could well have been with John Thaw - would anyone have recognised him in 1973, before the Sweeney?

[SheffieldJane in reply to PMRpro]

We saw Stephen Mangham the last time we went to J Sheeky’s restaurant. I love Portrait Artist of the year. - and my toes were run over by Danny La Rue’s car, years ago, outside the theatre and he spoke to me. 😂😂😂

I am going to be drummed out of the Brownies at this rate.

[Stills in reply to PMRpro]

Is it the soy that’s bad for us? I’m just starting paying more attention to my food due to digestive issues that started after emotional trauma and stress early this year. ‘Oscopies, scans and meds inconclusive and ineffective thus far although ER said dipping BP issues. Any way I’m being more aware especially as already veggie. I eat pumpkin seeds, almonds, cashews a few Brazil nuts, avoid fatty snd processed stuff, trying to eat high fibre and more fish and dark fruits, almost t-total and never ever eat junk food. I’m hoping this is all good.

PS: not trying to lose weigh but just avoid bad stuff

[PMRpro Ambassador in reply to Stills]

I was thinking more in terms of the spices that might upset a delicate digestive system. Natural flavourings covers a lot of things.

[SnazzyD]

one of my surprise crises even after stopping Pred was due to a holiday. There are so many aspects that put stress on the body and mind, even with a successful holiday. The only time we notice is if cortisol isn’t as available as it might be. Increasing to 5mg for a day or two might give you information you need to work out what is going on.

[Temoral in reply to SnazzyD]

Thank you all...5mg won't do any harm for a couple of days , when looking at the long view! And as you wisely say, it will allow a look at other things. I haven't flown for about 4 years, so that could be the stress trigger I suppose.

[DorsetLady PMRGCAuk volunteer in reply to Temoral]

Most definitely to your last sentence…..

[SnazzyD in reply to Temoral]

I was reading an article a while back on the effect of low pressure in planes on the body. It made me realise why after 2 hours I feel a bit weird and after 4 hours, just horrible. I’m laying to rest my dream of going to Oz/NZ! Of course people differ but even if you are feeling it was fine, there is stuff going on internally.

[PMRpro Ambassador in reply to SnazzyD]

It is also the lack of O2 - the air stagnates in certain areas plus they turn the level down overnight when they expect passengers to be asleep. If you are in the wrong place in cattle-class ...

Both I and a medic friend experienced it - really wasn't nice at all. But we then knew enough to make a fuss if we felt it happening again.

[SnazzyD in reply to PMRpro]

Ah, so perhaps the reason I wake up feeling terrible.

[PMRpro Ambassador in reply to SnazzyD]

Could be - and while you are asleep your O2 sats would be even lower. My friend was quite dramatic about getting the O2 turned up - she got up and collapsed in the aisle, She is a statuesque lady

[Temoral in reply to SnazzyD]

I would live to go to NZ, but I think I would not be able to cope with the long flight...boat option? 😉🤣

[Broseley in reply to Temoral]

We went to NZ in 2020. I chose Singapore Airlines through a recommendation and they were fab. I was really worried about sitting for so long (13 hours to Singapore) with my back issues and sciatica but the seats were so comfortable I didn't need the air cushion I took with me. We stopped at Singapore for 3 days before continuing to NZ. I would highly recommend this, it's an amazing place!

[DorsetLady PMRGCAuk volunteer in reply to Broseley]

Certainly is...did that on my first trip to NZ... but not on second. As you know daughter lives there... and agree on SA..

[Stills in reply to SnazzyD]

That’s worrying…. Short two hour flights are not too bad but (all being well) we’re off to Thailand in February. It’s a very delayed honeymoon, 13 years late actually as there was some sort of coup and unrest in 2010 so we couldn’t go and had two weeks in Alicante at the last minute instead.

[DorsetLady PMRGCAuk volunteer in reply to Stills]

I flew to NZ when I was on 7mg -and again when I was off it. ..no problems whatsoever.

Don’t assume the worse.. it doesn’t happen to everyone.

[Stills in reply to DorsetLady]

Thank you for the reassurance

[SnazzyD in reply to Stills]

As DL says it isn’t something that everyone is worried by.

[Blearyeyed]

You wouldn't usually increase Pred for IBS pain , partly because steroids are one of the drugs that could make it flare more .Do you have any medication that you take specifically for IBS pain , like Buscopan or Mebeverine.

Rest , water , paracetamol and small, light , bland foods is really the only way to help with the pain and stop the dehydration.

You could try Imodium for the diarrhoea if you have a place to go but it's not always effective with IBS-D.

Live Yoghurt would be soothing but you may want to be careful depending on what is available where you are.

Are you sure that the IBS is the cause of the pain or bloating?

Could it be a bug or food intolerance?

If it is food poisoning or an upset stomach rather than IBS Imodium may well work , and it could be over in a couple of days . You could choose to wait to do an increase in steroids to see if normal treatments are enough if you aren't having a PMR flare.

Or do just a slight increase of steroids for a couple of days if you can feel PMR symptoms or really feel that this illness will cause a flare.

How horrible for it to happen on a holiday , hope you feel better soon, Bee

[Temoral in reply to Blearyeyed]

Thank you Bee for your very balanced reply. I drank lots of water yesterday and just rested. A storm overnight has reduced the humidity....First rain here since February! and symptoms have calmed too. Perhaps it was a holiday a bug which set off the IBS. Thank you again, take care.🙏

[sidra1968]

ugh, have IBS too and it can come on just from travel sometimes..or really no reason at all that I can find many times. I use the liquid immodium and it seems to calm things down a little, but only time seems to get me back to "normal"

[Temoral in reply to sidra1968]

Hi Sidra...yes, patience and quiet and the eventual return to the 'new normal'. Thank you, take care.