Stomach Problems and Steroids

Gwyn, are you taking enteric coated Prednisolone?  If so, you may not need the Omeprazole unless you already had gastric problems before diagnosis.  I was prescribed Omeprazole alongside the steroids and had horrendous stomach problems almost immediately.  As soon as I stopped taking it, my tummy returned to normal.  I was tried on another PPI (Lansoprazole) but that also caused problems and was also stopped within a few days.  To protect my stomach from any possible steroid side effects, I decided to eat a 'live' (probiotic) yoghurt with my breakfast each morning, before taking the steroids.  It obviously acted as a good stomach liner because I never had any more problems throughout my years on steroids.

Most of us find sleep difficult but once you are down to the lower steroid doses you should find sleep easier.  Meanwhile, ensure that you take the steroids early in the morning, and try and have catnaps during the day.

I do hope you feel better soon.

The most likely cause of the stomach problems is the omeprazole. Other PPIs can also cause similar problems so if you definitely need "stomach protection" as they call it ask your doctor for ranitidine (Zantac) which is a completely different drug and many gastroenterologists wonder why PPIs are so popular with GPs!

I have never taken a PPI and have had no problems. Like MrsO I used yoghurt when I was on ordinary pred and the rest of the time I have had an enteric coated version - not broken down in the stomach so less need for antacid medication.

Is it the diarrhoea or the pred that's keeping you awake? If it is the pred that will improve as the dose falls. In the meantime just try to rest when you can. Lots of people get up and read or do computer things and settle down for a sleep any time it fits.

Hi Gwyn57, just wondering how you and your tummy problems are 1 year down the track ? After about 1 year on prednisone  I have now developed really unpleasant digestive problems I have severe reflux,stomach/intestinal cramping and runs and endless burping,  Like Mrs O I am worse on PPi's. I have yoghurt daily. I cannot have honeybecause of (lichen planus another auto immune disease). I have cut out so many foods trying to find the culprit. I do not know if my pred is coated or not - must find out. Have you found a solution to your gastric problems ?

Don't be disappointed if you don't get a reply. Although all this thread says is "over a year ago" it must be more like nearly 4 years or more ago judging by the names who contributed to the discussion and me talking about mixing enteric coated and ordinary pred tablets, I haven't taken them for 5 years!

Hi Flutterbie

i too have acid reflux so it sounds like it's not as bad as yours. There have been quite a few posts offering ideas about this. If you look back on the topics there is one on silent acid reflux with lots of posts in the link within that topic and one today I think called stomach problems.....not sure how to look at topics and also not lose what I have written!

i finally had improvement when I started putting my plain white Pred into gel capsules (my pharmacy sells them) and I've recently been experimenting with making green juice. I've read others are putting their Pred into enteric coated gel capsules and I plan to start that next - have to get some family visits completed before I try something new with my Pred. 

Topic is Reduction

Has your supplier changed? Sometimes the fillers in the tablets are different - they can be implicated in upset stomachs too. And I'd combine all available options if I had problems, not one or the other.

Eileen, do you mean the fillers in the pred ?

Yes - all tablets are made up of the active substance plus a load of other things to be able to form a tablet including colourings and stabilisers. Each company uses something a bit different and that can make quite a bit of difference to some people. 

So if you have a tablet from a particular company that you find works well with few side effects but another isn't so good then it is worth trying to get your pharmacy to get the one that suits you. You have to get your doctor to write that on the prescription though - the name of the brand if that applies and that only this version should be dispensed. Sometimes if it is a generic you have to shop around to find a pharmacy that will get the one you need.

Thanks Eileen. The generic version of Losec did not work for me in the past, so I did check about them, but it never occurred to me that Prednisone could come from different places as well. I will discuss it with the Dr and Chemist. I have been through a horrible few months with entire digestive system, which has improved at the moment. No obvious reasons have been found as yet for the problems which did begin suddenly. I want to be prepared in case they ever return.

Losec is a common cause of gastric problems all the way through - and it doesn't always start immediately. The same applies to other drugs with the potential - side effects can appear later on. It's one of the things keeping a diary can be helpful for - changes of medications/doses and changes in symptoms in a diary may show up a relationship.

What other medications are you on?

I have got a bit lax with my diary over the last few months - big mistake ! I am taking Loxamine, Prednisone and Ranitidine (another ppi). I was taking a few other things like vit b, magnesium, vit d, but stopped all for a few weeks, including wine. I have reintroduced red this week and think it has passed the test. a good start.

Ranitidine isn't a PPI, it's an H2 histamine receptor antagonist - it is a different mechanism although it produces the same effect as a PPI and has different, generally fewer side effects. That's just me being picky...

So did you recently change from omeprazole to ranitidine?

I knew that​ - I was going to say i suffer from pred brain as well, but you have an excellent memory, so maybe I shouldn't blame my vagueness on pred.  I had a second ppi inbetween, which upset me badly within half hour of taking it. I took it 6 times and had an immediate bad  reaction every time. I have been on Ranitidine for a few weeks. I got no relief for the first 2 weeks. I now have relief from an unexpected source (a French Osteo). I just couldn't understand why omeprazole had worked well for me for a long time, then major problems flared up.

I did have horrible concentration and memory problems at the start of PMR and pred made it worse for a while. It has improved dramatically since being on Lodotra - whether it is just the prednisone rather than prednosolone or methylprednisolone or whether Lodotra really is associated with far fewer side effects I have no idea! It is good to be back to "normal" - or what passes as normal for me...