Resolution of multiple severe colonic strictures with prednisone therapy: CASE PRESENTATION (Part 3)

Because her duodenal lesions had resolved with no obvious change of her colonic lesions, 5-aminosalicylic acid treatment was discontinued and an empiric course of prednisone was given at an initial dose of 40 mg per day. She was discharged to a convalescent hospital and given intensive rehabilitation in preparation for knee replacement surgery. Because her lower abdominal pain was still present and elective surgery was planned, a repeat colonoscopy was performed May 15. At this time, only two weeks after the initiation of prednisone, her symptoms had improved and there was already significant healing of her colopathy. The left colon was observed to be normal and the strictures of her transverse colon were diminishing. The ascending colon remained normal. Prednisone treatment was decreased to 30 mg per day for two weeks, then 20 mg per day, a dose that was considered safe for her to take perioperatively.

The patient had her knee replacement surgery with further physiotherapy and remained on prednisone 20 mg per day. As the optimal duration of therapy with prednisone was unknown, it was decided to repeat colonoscopy after approximately 17 weeks, a duration adequate to induce healing of other causes of colonic inflammation such as Crohn’s disease. After 20 weeks of prednisone therapy, her colonoscopy was entirely normal and there was no trace of her previous ulceration or stricturing (Figure 2). Her hemoglobin had risen since her initial hospitalization and she required no transfusion at the time of her knee replacement. She had no further evidence of gastrointestinal bleeding and had begun regaining the weight she had lost. Her prednisone, which had been taken with no significant side effects, was tapered and discontinued. This is your opportunity to buy cheap cipro click here taking full advantage of the nice options offered to you by most reliable pharmacies on the internet, with free delivery, express shipping and tons of other options you will appreciate.

Healed transverse colon

Figure 2) Healed transverse colon following a 20-week course of prednisone therapy

Category: Prednisone therapy

Tags: Anti-inflammatory agents, Colonic diseases, Non-steroidal, Prednisone

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