How Long Does It Take for Prednisone to Work in IBD?

Prednisone is a fast-acting medication that should provide relief for acute symptoms of Crohn’s disease or ulcerative colitis within a couple of days.

Chances are if you’re prescribed oral prednisone for your Crohn’s disease or ulcerative colitis (UC), you’re feeling unwell and need some symptom relief!

You may be wondering, “How soon until prednisone starts working?” The good news is that prednisone works quickly in inflammatory bowel disease (IBD), usually decreasing pain and inflammation within a few days.

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What is prednisone?

Prednisone is a corticosteroid, or a human-made steroid that mimics cortisol, a natural hormone produced in your body. It’s used to decrease inflammation throughout your body by suppressing your immune system.

Prednisone is approved to treat a wide variety of autoimmune, inflammatory, and allergic conditions.

How does prednisone work for Crohn’s and ulcerative colitis?

In Crohn’s and UC, your body’s immune system attacks your gastrointestinal (GI) tract, causing inflammation and damage to the lining of your intestines.

Prednisone works for Crohn’s and UC by stopping your body’s production of inflammatory proteins called cytokines. This limits the activity of your immune system and controls inflammation in your intestines.

Doctors commonly prescribe prednisone when someone is initially diagnosed with Crohn’s or UC, or is experiencing an acute flare in symptoms. It’s a strong drug that can reduce the symptoms of IBD quickly, but it’s most effective for short-term use. Studies show that prednisone cannot maintain remission long term.

How long does prednisone take to work?

Prednisone is a fast-acting drug. It’s absorbed into your body within a few hours. If you’re taking a higher dose, you may feel your IBD symptoms start to calm down the first day you take prednisone. Most people notice improvement of symptoms during the first few days of treatment.

How can you tell if prednisone is working?

You’ll know prednisone is working to reduce inflammation in your intestines when symptoms such as pain, diarrhea, and bleeding improve.

Talk with your healthcare professional if your IBD symptoms do not get better within 7 days. You may need a higher dose or your doctor may need to change your treatment. Although prednisone works to improve symptoms in most people with acute IBD, it does not work for everyone.

What are the side effects of prednisone?

Prednisone is a systemic drug, meaning it affects your entire body. Therefore, it has side effects throughout your body. The side effects increase with higher doses and length of treatment. Keep in mind that your doctor considers the benefits of symptom relief to outweigh the possibility of side effects.

Some common side effects include:

• mood swings
• difficulty sleeping
• water retention or rounding of the face
• weight gain
• increased appetite
• headache
• acne

Common side effects go away after you finish taking prednisone.

More serious side effects include:

• high blood pressure
• high blood sugar
• osteoporosis
• cataracts or glaucoma
• infection or delayed wound healing
• psychiatric symptoms
• adrenal insufficiency

Serious side effects are more likely with prolonged treatment. The goal of treatment should be to take prednisone for a limited time to prevent serious side effects.

What to avoid when taking prednisone

Some medications have negative interactions with prednisone, so you should avoid taking them while you’re being treated with the corticosteroid. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, aspirin, and Naproxen are examples of NSAIDS, which can cause stomach irritation and increase the risk of ulcers when combined with prednisone.
• Live vaccines: Due to immune suppression, live vaccines can potentially cause an infection in someone taking prednisone.
• Anticoagulants: Prednisone may increase the effects of blood thinners like warfarin, so if you’re taking an anticoagulant, your doctor may want to adjust your dosage before starting treatment with prednisone.

Talk with your doctor or pharmacist about any other medications you’re taking. Prednisone may also alter the effects of certain antibiotics, diuretics, and diabetes medications.

You should also avoid:

• Alcohol: Alcohol can worsen inflammation and side effects of prednisone.
• Salty and sugary foods: Limiting high sodium and especially sugary foods can help prevent side effects of fluid retention and blood sugar changes.
• Caffeine: Reducing caffeine intake helps reduce sleep disturbances while taking prednisone.

FAQ

Do I have to take prednisone at a certain time?

Yes, ideally you should take it before 9 a.m. to help prevent insomnia. If you’re taking more than one dose per day, space them evenly as directed by your doctor.

Take prednisone with food to avoid an upset stomach. If you’re taking a higher dose, your doctor may recommend antacids between meals to prevent stomach irritation or ulcers.

If you’re at risk for osteoporosis, your doctor may want you to take calcium and vitamin D along with your prednisone, especially if you need to stay on it for longer periods.

Why do I have to taper off prednisone?

It’s very important to slowly decrease your dosage of prednisone as instructed by your doctor. Prednisone causes your body to produce less cortisol. Tapering off gradually is necessary to allow your body to start producing cortisol normally again.

If you stop taking it suddenly, you’ll likely feel symptoms of cortisol withdrawal such as fatigue, muscle aches, nausea, joint pain, and changes in blood pressure or blood sugar levels. Tapering will also help prevent relapse of IBD symptoms.

Who should not take prednisone?

Prednisone may not be safe for those with the following conditions:

• high blood pressure
• heart failure or recent heart attack
• diabetes
• osteoporosis
• glaucoma or eye infections
• fungal infections
• wounds
• mental health conditions

Talk with your doctor about any other conditions you have before taking prednisone.

The takeaway

Prednisone is a powerful and effective anti-inflammatory medication commonly used for short-term IBD symptom relief. It works within days to help your Crohn’s or UC improve. Side effects are common and can be limited with shorter treatment.