9th June 08:00
A question about Prednisone. (stress malaise colitis ulcerative)
This should help convince your doc.
Aseptic necrosis is a condition in which there is death and degeneration of
the hip bone. It is a painful condition that can ultimately lead to the need
for surgical replacement of the hip. Aseptic necrosis also has been reported
in the knee joints. It is not known how corticosteroids cause aseptic
necrosis. The estimated incidence of aseptic necrosis among corticosteroid
users is 3-4%. Patients on corticosteroids who develop pain in the hips or
knees should report the pain to their doctors promptly. Early diagnosis of
aseptic necrosis with cessation of corticosteroids might decrease the
severity of the aseptic necrosis and the need for hip replacement surgery.
Prolonged use of corticosteroids can depress the ability of the body's
adrenal glands to produce cortisol (a natural corticosteroid necessary for
proper functioning of the body). Therefore, abruptly discontinuing
corticosteroids can cause symptoms due to a lack of natural cortisol (a
condition called adrenal insufficiency). Symptoms of adrenal insufficiency
include nausea, vomiting, and even shock. Withdrawing corticosteroids too
quickly also can produce symptoms of joint pain, fever, and malaise.
Therefore, when corticosteroids are discontinued, the dose usually is
tapered gradually rather than stopped abruptly.
Even after corticosteroids are discontinued, the adrenal glands' ability to
produce cortisol can remain depressed from months up to two years. The
depressed adrenal glands may not be able to produce increased amounts of
cortisol to help the body handle the stress of accidents, surgery, and
infections. Therefore, patients need additional corticosteroids during
stressful situations to avoid developing adrenal insufficiency. Because
corticosteroids are not useful in maintaining remission in ulcerative
colitis and Crohn's disease, and because they have predictable and
potentially serious side effects, they should be used for the shortest
possible length of time.