Weight control by not taking steroids properly

[Serendipitelle]

Hi there

I have severe active Crohn's disease and an eating disorder (bulimia) (both for over 20 years).  I am MEANT to be on a prednisolone regime of 60 mg daily, reducing by 20 mg every 2 weeks, settling at 20 mg until full remission is confirmed.  However, as I am still binging, my weight gain is astronomical (something I cannot tolerate due to the eating disorder).  It is approximately 10 to 14 pounds in a week.  

As a result, I panic and reduce the steroids to 5 mg in the course of a week.  It then takes only a few days for all my symtoms, currently painful recurring partial small bowel obstruction, to reoccur.  At which point, the pain becaoes intolerable and I go back to 60mg steroids for some almost instant relief.  And then the cycle continues again.  i have been doing this for a few months now.

Obviously I know that this is not a reat thing to be doing, but does anyone know if I could be causing any harm or damage to myself here.  (No need to comment on harm caused by eating disorder, please!).

Thanks for any advice.

[CalGal]

You are unfortunately doing harm in a couple of ways. You're yo-yoing with the steroids, so you're unfortunately jacking your own natural production system of producing steroids around rather severely. It's hard enough for many who have any form of IBD to get down off the steroids once they're on them because there's a small feedback loop in the body that needs to be reactivated once you come down off prednisone. As I'm sure you know, many with IBD find they reach a lowered level of intake of prednisone, and they can't get down any lower. It means they're steroid-dependent, and they're unfortunately going to be on steroids for most of their lives.

Despite the fact that steroids can help tamp down the inflammatory response that's going on in your system, they also have rather miserable side-effects that can include severe bone loss, along with all the other side-effects your probably know pretty well by now.

In addition, if you can't keep the inflammatory reaction tamped down, it's not only continuing to damage your intestinal system, but those antibodies you're producing can also act at other sites in the body, such as your joints and spine.

If you can't handle the steroids, you've got to 'come clean' with your doc and try to find other medications that can act on the inflammatory response. IBDs are hard enough to handle with steady doses of meds.