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What Causes Back Pain And Swollen Stomach Despite Prednisone Usage?

Posted on Sat, 13 Sep 2014

Question: I have adrenal insufficiency. The last time I stopped taking prednisone I ended up in the hospital with psychosis for 2 weeks. I moved from XXXXXXX to Rapid City, S.D. I was a patient of Dr. Iweha, Endocrinologist. She recommended prednisone 10mg BID. I finally received my approval for Medical Retirement through the Federal Government in May, but I am still receiving interim benifits . I have some days where I have a lot of pain in my back, swelling of my stomach, pain in my chest & pills sticking in my throat. I also have a history of MG s/p robotic surgery to remove a spindal cell thymoma.

Answered by Dr. Binu Parameswaran Pillai (24 minutes later)

Brief Answer:
Hello

Detailed Answer:
Hello,
Good day,
Noted your history.
Prednisone is a strong steroid and you are taking 20 mg per day. This is fairly large dose. What is your height and weight ?

In my clinical practice, i use hydrocortisone tablet instead of prednisone. It is more milder and better on bones. Your dose of prednisone will cause weak bones ( osteoporosis), fractures, diabetes, high blood pressure, acidity etc.

Noted the symptoms of stomach and chest pain. This could be due to steroid induced acidity. You are also taking Aleve for pain. Aleve is Naproxen. Prednisone and Naproxen, both are notorious to cause stomach ulcer and acidity.

Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (59 minutes later)

I was not clear! Dr. Iwaha gave me a prescription for prednisone 20 mg BID in 2012. I only took the predisone for 1 month after my thymus glad surgery on 9/13/12 because of a prolonged cough that I had for 4 months in the fall of 2012. I called the office for a follow up but got no response. I tapered myself off the prednisone in spring 2013 resulting in psychosis & a 2 week hospital stay where I was treated with Predinsone, Rispirodone, & Trileptal, of which I am not taking any steriods anymore. I have already had 2 stress fractures in my left heel, & several rib fractures from falling secondary to my poor balance. I have been off steroids since April 2013. Would taking hydrocortisone instead of prednisone improve my stomach symptoms?

Answered by Dr. Binu Parameswaran Pillai (2 hours later)

Brief Answer:
Hi

Detailed Answer:
Hi,
It is much clearer now. Since you are off any steroids since 2013 and has had nil issues so far, it is unlikely that you have major adrenal insuffciency. You may need a short synacthene test to decide the level of adrenal insufficiency. In the current situation, i will not advice you to start on hydrocortisone before doing a short synacthene test.

Your stomach symptoms seems to be secondary to Naproxen. You may either stop and change over to paractemaol. You may also need drugs like Omeprazole for stomach protection.

Since you had fractures, it is advisable to do a DXA scan to rule out osteoporosis and then start on preventive measures to avoid fractures in the future.
It is good to take calcium and vitamin D for bone protection

Binu

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar