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What Causes Abdominal Pain, Bloating And Shoulder Pain Inspite Of Weaning Off Prednisolone?
Question: I gave ulcerative colitis (most of the pain has been rectal). I recently started having the following others symptoms...
Mid- abdominal pain (seems to be gas related), gas, bloating, no appetite (I actual feel nauseated just putting food in my mouth at times), stabbing pain between my shoulder blades (right side), a bad taste in my mouth, fatigue and some had and feet cramping with no real reason. I'm just wondering if it could be a separate issue from the UC.
I'm weaning off prednisone (15mg now), 2nd dose of a Remicade was two weeks ago and I am on Lialda.
Thanks,
XXXXXX
Mid- abdominal pain (seems to be gas related), gas, bloating, no appetite (I actual feel nauseated just putting food in my mouth at times), stabbing pain between my shoulder blades (right side), a bad taste in my mouth, fatigue and some had and feet cramping with no real reason. I'm just wondering if it could be a separate issue from the UC.
I'm weaning off prednisone (15mg now), 2nd dose of a Remicade was two weeks ago and I am on Lialda.
Thanks,
XXXXXX
Brief Answer:
Not UC....
Detailed Answer:
Dear XXXXXX,
I went through the details you provided with diligence. And I don't think the new complaints are directly related to ulcerative colitis. Most of your complaints are likely to be related to prednisolone therapy. Let me explain that.
Steroid is a wonderful antiinflammatory drug. But there are few side effects that routinely follow with its use. Gastritis / GERD and hypocalcemia are couple of side effects besides others. Abdominal pain, bloating, nausea and bad taste seems to be from gastritis / GERD. Muscle cramps may be due to electrolyte change - low calcium. I consider the steroid induced side effects as the first probable diagnosis in the context of these symptoms.
Gall stones is next in line. Indigestive symptoms, abdominal pain and referred pain to the shoulder are common complaints with gall bladder inflammation.
I would suggest you call your doctor and discuss about using proton pump inhibitor or antacids or both. I guess that should solve this problem. You are also requested to make some dietary restrictions - low spices, low caffeinated beverages and low fat diet. If symptoms don't improve, I would order for an ultrasound examination, a complete hemogram, serum electrolyte and metabolite panel check up including serum calcium level estimation.
Hope I am clear. I will be glad to discuss further in case you need clarifications.
Best Regards
Not UC....
Detailed Answer:
Dear XXXXXX,
I went through the details you provided with diligence. And I don't think the new complaints are directly related to ulcerative colitis. Most of your complaints are likely to be related to prednisolone therapy. Let me explain that.
Steroid is a wonderful antiinflammatory drug. But there are few side effects that routinely follow with its use. Gastritis / GERD and hypocalcemia are couple of side effects besides others. Abdominal pain, bloating, nausea and bad taste seems to be from gastritis / GERD. Muscle cramps may be due to electrolyte change - low calcium. I consider the steroid induced side effects as the first probable diagnosis in the context of these symptoms.
Gall stones is next in line. Indigestive symptoms, abdominal pain and referred pain to the shoulder are common complaints with gall bladder inflammation.
I would suggest you call your doctor and discuss about using proton pump inhibitor or antacids or both. I guess that should solve this problem. You are also requested to make some dietary restrictions - low spices, low caffeinated beverages and low fat diet. If symptoms don't improve, I would order for an ultrasound examination, a complete hemogram, serum electrolyte and metabolite panel check up including serum calcium level estimation.
Hope I am clear. I will be glad to discuss further in case you need clarifications.
Best Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your response...
Just a couple follow up questions...
- I am in the process of weaning of the Prednisone...I go to 10mg tomorrow. How long will it stay in my system when I am totally off the Prednisone?
- I forgot to mention I have tingling/numbness in my feet...would that also be related to the Prednisone?
Thanks again,
XXXXXX
Just a couple follow up questions...
- I am in the process of weaning of the Prednisone...I go to 10mg tomorrow. How long will it stay in my system when I am totally off the Prednisone?
- I forgot to mention I have tingling/numbness in my feet...would that also be related to the Prednisone?
Thanks again,
XXXXXX
Brief Answer:
It depends...
Detailed Answer:
Prednisolone has intermittent duration of action when compared to other steroid (there are short acting and long acting ones). If you had been on is 3 - 6 weeks of Prednisolone, the effects may last upto 2-4 months. However the side effects disappear much earlier. So if I were you I would not be worried about short steroid therapy treatment.
As far as tingling and numbness, they are not the usual side effects reported with steroid treatment. I will order blood tests if the complaints persist after the steroid withdrawal. Follow up with your treating doctor to discuss about the fresh complaints as well as for drug prescription.
Regards
It depends...
Detailed Answer:
Prednisolone has intermittent duration of action when compared to other steroid (there are short acting and long acting ones). If you had been on is 3 - 6 weeks of Prednisolone, the effects may last upto 2-4 months. However the side effects disappear much earlier. So if I were you I would not be worried about short steroid therapy treatment.
As far as tingling and numbness, they are not the usual side effects reported with steroid treatment. I will order blood tests if the complaints persist after the steroid withdrawal. Follow up with your treating doctor to discuss about the fresh complaints as well as for drug prescription.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks again...
I have a follow up appointment late this week.
I wanted to add a symptom that I forgot...not sure if it means anything but stool color is a yellowish and often undigested food present. My white blood count was high on my last blood test (6 weeks ago)...1,348.
Thanks for your help...it will make my visit more productive.
XXXXXX
I have a follow up appointment late this week.
I wanted to add a symptom that I forgot...not sure if it means anything but stool color is a yellowish and often undigested food present. My white blood count was high on my last blood test (6 weeks ago)...1,348.
Thanks for your help...it will make my visit more productive.
XXXXXX
Brief Answer:
Let your doctors reassess you now...
Detailed Answer:
Stercobilinogen is a bilirubin metabolite that is excreted in the stool. It imparts the golden brown color to the stool. Sometimes the excess stercobilinogen makes stool yellowish. I wouldn't be concerned if there are no floating globules (floats in water) and you have no signs of jaundice.
As far as undigested food particle is concerned, it may be due to GERD or part of inflammatory bowel disease. It is not an immediate concern. Continue to follow the diet as instructed and the drugs prescribed. Discuss about starting proton pump inhibitors during the follow up visit.
You can also talk about warning / concerning symptoms with the treating doctor. There are many vague / broad symptoms mentioned on the web; all are not true. Understanding the disease process, a proper diet, religious medications and regular follow up will help you lead healthy life.
Hope this discuss was fruitful. Do not forget to close this discussion if you have no more questions.
Wish you good luck!!
Let your doctors reassess you now...
Detailed Answer:
Stercobilinogen is a bilirubin metabolite that is excreted in the stool. It imparts the golden brown color to the stool. Sometimes the excess stercobilinogen makes stool yellowish. I wouldn't be concerned if there are no floating globules (floats in water) and you have no signs of jaundice.
As far as undigested food particle is concerned, it may be due to GERD or part of inflammatory bowel disease. It is not an immediate concern. Continue to follow the diet as instructed and the drugs prescribed. Discuss about starting proton pump inhibitors during the follow up visit.
You can also talk about warning / concerning symptoms with the treating doctor. There are many vague / broad symptoms mentioned on the web; all are not true. Understanding the disease process, a proper diet, religious medications and regular follow up will help you lead healthy life.
Hope this discuss was fruitful. Do not forget to close this discussion if you have no more questions.
Wish you good luck!!
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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