OpenHealth Q&A

Questions About Tapering Off Prednisolone During a Crohn's Flare

I suspect I’m experiencing a flare-up of Crohn’s disease, as MRI Enterography has indicated increased thickness in the bowel walls of my jejunum, terminal ileum, and recto-sigmoid area. Unfortunately, due to complications with border crossing while studying abroad, I need to repeat my tests. Previously hospitalized, I was stabilized at a dosage of 40mg of prednisolone and am now gradually tapering off to prepare for a confirmatory endoscopy and capsule camera examination. Currently, I’m at 20mg, and I will be reducing it to 10mg starting tomorrow for one week. I know this isn’t ideal. It feels as if I’m just biding my time until I might need to be hospitalized again before the testing can occur. But let’s set that aside for the moment. I’m experiencing significant menstrual cramps, which I suspect have worsened due to an unintentional weight loss of about 10kg. I'm particularly anxious about how these next two months of tapering off will affect me. I know it sounds silly, yet this was a major factor in my last hospital visit. My body became overwhelmed, leading to a severe reaction where I couldn’t stop shaking and my blood pressure plummeted. My cramps were already intense, but they have escalated notably during this flare-up. I cannot take NSAIDs and will be relying on Tylenol, but I’ve found it to be ineffective in the past. I’m reaching out to see if there are alternative options. **I primarily want to know if any of my proposed remedies could be advisable or harmful given my current medications.** At present, my medications consist of: *Daily: Prednisolone 20mg (soon to drop to 10mg), Pantoprazole 20mg; As needed: Ondansetron 4-8mg, Dicyclomine 20mg, Simethicone 125mg, Diazepam 5mg (only for muscle tremors), Vitamin D 3000IU.* I’m particularly interested in the safety of the following supplements: 1. Magnesium glycinate (200mg or less) combined with B6 (25mg) – I’ve seen some studies online suggesting these may help. 2. Calcium – My former OB/GYN informed me years ago that studies indicated it could alleviate PMS symptoms. 3. Parabrom or another remedy for bloating? (I’ve found non-antihistamine Midol contains this.) I’m a 27-year-old female, standing 1.62m (approximately 5ft4in) and weighing 42kg (about 92lbs). I have Crohn’s disease and GERD, and I’m currently on the medications listed above. I do not use drugs or alcohol. My current symptoms include intense urgency, tenesmus, cramping, abdominal pressure, abdominal pain (especially on the lower left side, but also throughout), unintended weight loss, mucus in stools, mild joint discomfort, fatigue, hair thinning and changes in texture, as well as oddly enough, constipation even though I’m dealing with tenesmus and an urgent need to go to the bathroom. Thank you for taking the time to read this; I’m unable to reach my gastroenterologist in a timely manner, which is why I’m seeking advice here!

Answers (1)

9/3/2025, 4:50:50 AM

OpenHealth AI

I understand that you are experiencing a difficult situation with your Crohn's disease and the accompanying symptoms, particularly during this tapering process of prednisolone. It's completely reasonable to have concerns about managing your symptoms effectively while also ensuring safety with your current medications. Let's focus on the options you mentioned and prioritize some actionable steps.

Summary of Key Points:

1. You're correctly tapering off prednisolone, but you have concerns about worsening symptoms, specifically menstrual cramps and abdominal discomfort.
2. You want to know the safety and effectiveness of certain supplements while considering your current medications.

Safety and Effectiveness of Proposed Remedies:

1. Magnesium Glycinate and Vitamin B6:

   • Safety: Magnesium itself is generally safe and can help with muscle relaxation, which might alleviate cramps. B6 can also support overall health.
   • Recommendation: Avoid exceeding the recommended dosages (200 mg for magnesium and 25 mg for B6). Monitor how you feel after starting to ensure there’s no negative reaction.

2. Calcium:

   • Safety: Calcium is usually safe, but be cautious as it can occasionally cause gastrointestinal discomfort, especially if you have GERD.
   • Recommendation: If you choose to take it, ensure it’s a low-dose formula and monitor any effects on your cramps.

3. Parabrom (often found in products like Midol):

   • Safety: Parabrom is generally considered safe, but check for any specific contraindications with your current medications.
   • Recommendation: Use this with caution, and ideally, consult a pharmacist before trying it to clarify any interactions.

Actionable Next Steps:

1. Monitor Symptoms Closely: Take notes on any changes in your cramps and gastrointestinal symptoms after starting any of these supplements.
2. Stay Hydrated: Since Crohn’s can lead to dehydration, especially with weight loss, ensure you're drinking plenty of fluids and consider electrolyte solutions if needed.
3. Diet Adjustments: Focus on a balanced diet rich in nutrients to help manage your weight and support your overall health. Small, frequent meals that are low in fiber may ease digestive discomfort during this time.
4. Heat Therapy: Applying heat (like a heating pad) to your abdomen can help relieve cramping and promote relaxation.
5. Relaxation Techniques: Stress can worsen symptoms; consider gentle yoga, meditation, or deep-breathing exercises to help manage anxiety and muscle tension as you go through this taper.

If you notice severe changes in your symptoms or any newfound reactions to supplements or medications, reaching out to a healthcare professional, even a local pharmacist, would be prudent. Take care of yourself during this time, and don’t hesitate to ask for help from those around you.