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Relapsing active u colitis. Have lot of gas, constipation, slightly diabetic. Having rowasa 3gm, cortisone 5mg, isphagula. Advice?

DEAR DOC CHARLES
I AM HAVING ACTIVE U. COLITIS NOW FOR ALMOST 3 YEARS. PRESENTLY I AM TAKING 3 GMS OF ROWASA DAILY. I KEEP HAVING A RELAPSE EVERY 3 TO 6 MONTHS. I ALSO TAKE MESACOL ANEAMA REGULARLY ABOUT TWICE A WEEK.
ABOUT 20 DAYS AGO I WAS PUT ON CORTISONE 30 MG GRADUALLY TAPERED DOWN TO 10 CURRENTLY. LIKELY TO BE REDUCED TO 5MG.
I HAVE A LOT OF GAS AND SEVERE CONSTIPATION FOR WHICH I TAKE ISPPHAGULA 3TEASPOONS BUT TO NOT MUCH AVAIL.
WHAT IS A SAFE LAXATIVE AND CAN I CONTINUE TAKING 5 MG CORTISONE TO KEEP INFLAMATION IN CHECK.
I AM 74 YRS OLD LIVING IN INDIA AND AM SLIGHTLY DIABETIC.
PL. ADVISE AND THANKS
Asked On : Mon, 15 Apr 2013
Answers:  1 Views:  29
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Internal Medicine Specialist 's  Response
hi

You are suffering from severe ulcerative collitis

Prednisone/hydrocortisone should be considered for patients who have a more severe clinical presentation or who do not respond to the oral(full dose) and rectal mesalamine. The starting dose of prednisone is usually 40 to 60 mg/day, depending upon the weight of the patient and the severity of symptoms. This dose is usually effective within 10 to 14 days, after which the dose can be tapered gradually, usually by 5 mg per week. There is no evidence that chronic steroid therapy is effective for maintenance of remission; as a result, the goal is to taper and stop the prednisone with the initiation of maintenance therapy as described above

so as you are diabetic and studies have not shown improvement for long term steroids so follow tapering dose of steroids and as you are 47 yrs osteoporosis will be another problem

take care
Answered: Mon, 15 Apr 2013
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