Prednisone, GERDS, throat infection

[caregiver222]

Some physicians provide asthma patients with emergency supplies of oral prednisone tablets, to be taken in accordance with a specific short-term protocol.

These high doses compromise the immune system and the patient becomes vulnerable to opportunist infections. This is a mixed-bag because without the prednisone the patient may die from lack of oxygen.

In any event, the esophagus is very vulnerable to infection when eroded by stomach acid oozing through the esophageal sphincter. This is common with GERDS and acid-reflux syndromes. Normally the esophagus and trachea are very resistant to infection If there is acid refluc, the situation changes. The acid destroys the barrier to bacterial infection, and together with the prednisone the patient becomes prone to a sore throat, and infection which may rapidly progress to the lung.

Thus, the drill is, when on high-dose oral predisone, avoid esophageal acid erosion. I don't know why this information is not widely known.

This is accomplished by:

(a) not eating within two hours of sleeping.
(b) avoiding foods that contain methylxanthines (chocolate), which relax the sphincter.
(c) avoid "floor eating/snacking". Always eat while sitting in an upright position.
(d) sleep with the head at a thirty degree angle or more.

If you have a diagnosis of GERDS, make a special effort to keep things under control while taking the prednisone.


(c) consider taking an antacid while taking the prednisone.

[ill13632]

a lot of people say prednisone is destructive and has bad side effects
my main problem is I stop breathing in my sleep- does anyone else have sleep apnea?  I can't get enough therapy on my bipap for some reason

[ChitChatNine]

OUCH . .sorry to learn the med is so awful for you unless you use Carafate.  

[tiredmom76]

It doesn't matter if I take prednisone with food, it always tears my stomach up to the point where I have to take carafate(which is not great for your bones either) to heal it.  Antacids never heal the resulting gastritis (I've tried them all, );the carafte is the only thing that puts my stomach back together.But breathing is not optional, and luckily I don't have to take steroids that much.  Also it shoots up my blood sugar(and I am not diabetic) so I have to be extra careful when taking it.  But that said NOTHING else is like it when I really have to breathe, there is no good substitute.  

[bsmsl]

Good post caregiver222.

I would also recommend ALWAYS taking pred with food.  

Better yet, work hard to avoid taking pred.
1)  Make sure any underlying diseases are diagnosed and controlled - GERD, AERD, allergies (food)...
2)  BE PRO-ACTIVE - take maintenance meds on schedule EVERY day.  If ANY respiratory symptoms start (cough, runny nose...), go into yellow zone immediatedly (maximum dosage of resuce med at the shortest time interval).  

Pred is a terribly destructive med and should be avoided if at all possible.  However, not breathing well can be fatal, so sometimes you don't have a choice.

God bless

[1oftheclub222]

My father-in law use to take 10mg every day for years for his asthma...I think there are other things to worry about  besides your memory...his didn't seem all that bad, but his bones got bad...he shrunk alot!  I think at one time he was maybe 5'5" or a little taller, by the time he died I don't even think he was 5', he was hunched over and he was very puffy looking.  But if he didn't take it, he couldn't breath, so no option.

You have to weight the options for long term use.  For short term use, I have to give it to my son (also asthmatic) usually when he gets sick with a cold...his asthma gets so bad, it's the only thing that works for him...I hate it, but again, no option.

[ill13632]

my question too is if prednisone causes memory and brain damage to your neurons long term even at doses of 10mg/day

[ill13632]

it seems that even low doses of prendnisone can leave you open to herpes lip infections

hi!  an asthma sufferer told me spirulina and spinach and algae may help asthma
http://cat.inist.fr/?aModele=afficheN&cpsidt=13491008
she claimed she was able to stop inhalers
there was one dramatic story on an internet forum but safety?  also I ordered
amrita bindu an Indian mixture that was dramatic in on one study.
I also take boswellier extract and vitamin D, C

I think spirulina is available at vitamin shoppe, gnc

I have this wheezing on exhaling, might be vocal chords.  also when I take oxygen on bipap I seem
to feel much better and can think clearer.
it is a terrible, terrible suffering to have sleep apnea.

[ill13632]

I really need to know, how low do your FEV1, FEV1/FVC, peak flow meter scores have to be for there to be airway remodeling and risk of permanent scarring?
if your FEV1/FVC is above 100 are you safe or are there other measures or airway remodelling?

[ill13632]

I take nexium and zantac for my GERD.  treating GERD may help asthma and sleep apnea.  perhaps the acid causes inflammation.  it may also be better to avoid any spicy foods, allergic foods, nuts, milk, lemon, acidic foods

prednisone may cause brain damage long term to the hippocampus and the neurons there.  so getting steroidal injections or taking high doses seem questionable in some situations.

[Tammy2009]

Plus prednisone can cause or increase the amount you are refluxing.  

It normally didn't help my symptoms at all until the course was done because I have bad reflux.  I would use this medication only as a last resort with a history of GERD.