Diarrhoea Newly Diagnosed PMR

[Classicalgeeze]

I was diagnosed with PMR 4 weeks ago and commenced prednisalone 15mg which has been very effective. I started having acute diarrhoea 12 days ago that won’t go away and was wondering if anyone else has had a similar experience? Poo samples are negative to infection, loperamide is not working and despite repeated visits to GP they don’t seem to have any ideas about what’s going on. They just say to keep hydrated and eat as normally as possible and that it will eventually resolve…… and come back if it doesn’t get any better. I guess if I go back enough times they will eventually refer me for further investigation. Any ideas?

[DorsetLady PMRGCAuk volunteer]

Did you start any other medication at same time?

A PPI for example [anything ending in ..prazole] they very often are the culprit..

Some people also find too much calcium has similar affect.. are you on a VitD/Calcium supplement [usually that’s okay for most, although not all ] - or/and you taking more?

Hope you can soon get it sorted, it can be very debilitating..

[Classicalgeeze in reply to DorsetLady]

Thank you for your interesting advice. Yes I was commenced Omeprazole and calcium tablets on diagnosis. I stopped the calcium last week as I just couldn’t face them. On Dr’s advice I stopped the Omeprazole yesterday. Maybe I’ll start to see an improvement in couple of days when Omeprazole is out of my system

[DorsetLady PMRGCAuk volunteer in reply to Classicalgeeze]

Hope so... and on Omeprazole -most find taking Pred with food is sufficient... or in a spoonful of yogurt.

[Kendrew in reply to Classicalgeeze]

Just to add to DL's comment. I've been on prednisolone for 5yrs now and take them either after my breakfast or with some natural yogurt. So far I've not required a PPI.

[Highlandtiger in reply to Classicalgeeze]

I had hideous gastric problems when I started omeprazole (I was prescribed it along with pred when first diagnosed with PMR). They disappeared completely when I stopped taking them (with my GP's blessing).

[PMRpro Ambassador]

My question is already asked and answered. It could well be the PPI and calcium. My husband practically exploded on calcium carbonate, he was fine with calcium citrate though. PPIs have a record for causing very unpleast gut effects.

[SnazzyD]

Pred made me loose in the morning and on higher doses above 15mg it was worst. Omeprazole made things worse too, especially bloating and wind. Calcium gave me indigestion and reflux.

[LMali]

I am sure you will get better following advice of the experts, but for what it is worth, I have been on Pred for PMR since 2020 and in late 2022 I had diarrhoea which lasted a couple of months and for no apparent reason (according to the tests). My doctor was nice and we focused on improving general health (I started taking a hormone replacement pill and some vitamin and mineral supplements including B12 and folic acid as well as a multivitamin with iron). I also tried to focus on reducing stress in my life and gradually it just resolved itself. In a way, it would be better if it was caused by a specific thing, like omeprazole, then you could just stop taking the offending thing! I hope you start feeling better soon x

[Karendeena]

Happened to me 4 years ago. The 'prazoles' Lansoprazole was the culprit and I had to change PPI to a different sort. Unfortunately it was the slippery slope for me and I have had digestive issues ever since, even though I have been off prednisolone since January 2024

[S4ndy]

Omeprazole did that to me. Tried Pantoprazole and Lansoprazole, same thing constant diahorrea. My gastroenterologist suggested I go back to the more "old fashioned" H2 inhibitor Cetirizine. Did this and have had no problems with this drug as a stomach protector. My Rheumatologist sang the praises of H2 inhibitors over ppi's too and said that doctors tend to forget about them now they have all these ppi to choose from.

[LoveMygarden29]

hello! I too had these problems. My GP prescribed Famatodine which has solved the problem. Best Wishes Wendy