If you have a stomach pain condition, you might end up using a steroid called prednisone as part of your treatment plan.
Prednisone does two main things:
- It lowers your immune system response and reduces swelling.
- It works fast, which is great when you're having a painful episode of conditions like rheumatoid arthritis, lupus, or ankylosing spondylitis.
Source: Prednisone is a corticosteroid immunosuppressant
But there's a downside. Prednisone has a bunch of side effects, ranging from mild to really serious. This makes it not the best choice for long-term treatment.
One of these side effects is that prednisone can give you stomach pain and other digestive issues, even if you're only using it for a short time. Here's why it happens and what you can do to feel better.
What is Prednisone?
Prednisone is a type of steroid hormone called a glucocorticoid. It has an impact on various body processes, such as how your brain functions, how your body uses carbohydrates, and how your immune system responds to infections.
Prednisone is commonly used to reduce inflammation in the body. Some individuals may only need to take prednisone for a short period, like a few days or weeks, such as during an allergic reaction. Others may take prednisone regularly as part of their ongoing medication regimen, particularly for autoimmune disorders.
The side effects of prednisone can vary depending on the dosage and duration of use.
How Quickly Does Prednisone Work?
Prednisone can quickly improve severe and sudden symptoms of ulcerative colitis (UC). Its anti-inflammatory properties can help manage issues like stomach pain, abdominal pain, diarrhea, and bloody stools.
The Arthritis Society suggests that prednisone typically starts working within 1–4 days if taken correctly. However, some individuals may experience relief within just a few hours. The speed of its effectiveness can vary based on how it's taken and whether the drug is designed for immediate or delayed release.
Side Effects Of Prednisone
According to the National Institutes of Health (NIH), include:
- Upset stomach
- Vomiting
- Lightheadedness
- Swelling or pain in the stomach
If you experience any of these, it's crucial to contact your doctor right away. Sometimes, stomach issues can indicate a more serious problem.
For example: bad stomach pain, upset stomach, and vomiting could signal pancreatitis, which is inflammation of the pancreas—a severe medication side effect requiring immediate medical attention.
Source: A short course of 10 milligrams (mg) of prednisone a day may not cause side effects.
Additionally, severe upset stomach, vomiting, and decreased appetite might indicate an issue with the adrenal glands. Research published in the European Journal of Endocrinology suggests:
- Even low doses of prednisone can suppress the adrenal gland.
- Lead to acute adrenal insufficiency—a life-threatening condition where the adrenal gland doesn't produce enough cortisol.
Furthermore, long-term use of prednisone can weaken the body's immune response, potentially increasing the risk of small intestinal bacterial overgrowth (SIBO).
SIBO occurs when there's an overgrowth of bacteria in the gut, resulting in symptoms like gas, diarrhea, weight loss, and nutritional deficiencies.
Other Side Effects of Prednisone
Doctors are often cautious about prescribing prednisone for long periods because, while it's effective, it comes with a wide range of potential side effects.
According to the NIH, these side effects may include:
- Acne
- Bulging eyes
- Changes in body fat distribution
- Changes in personality
- Decreased sex drive
- Dizziness
- Difficulty sleeping
- Extreme mood changes
- Extreme tiredness
- Delays in growth and development in children
- Headaches
- Heartburn
- Increased hair growth
- Increased risk of osteoporosis
- Increased sweating
- Inappropriate feelings of happiness
- Irregular or absent menstrual periods
- Muscle weakness
- Red or purple blotches or lines under the skin
- Slowed healing of cuts and bruises
- Thin, fragile skin
More serious side effects, which require an immediate call to your doctor, include:
- Allergic reaction (signs such as itchiness, rash, hives, difficulty breathing, swelling of the face or mouth)
- Confusion
- Depression
- Eye pain
- Infection (signs like fever, cough, sore throat, chills)
- Irregular heartbeat
- Numbness and tingling
- Seizures
- Shortness of breath
- Shaking
- Twitching
- Vision problems
Given the numerous potential side effects of prednisone, it's crucial to contact your doctor if you notice any unusual symptoms or changes in your health—whether mental or physical—after starting this medication.
How to Manage Prednisone Stomach Pain
To manage stomach pain while on prednisone treatment, discontinuing the medication is the most effective solution, but this may not always be feasible for those addressing a health condition flare. However, there are strategies to alleviate stomach discomfort during prednisone use, starting with a discussion with your physician.
Source: The first and best way to avoid prednisone side effects is to take the drug as prescribed.
If you're on a high prednisone dosage and standard-strength proton pump inhibitors (PPIs) aren't providing relief, your gastroenterologist may consider:
1. Increasing PPI dosage
Your doctor may raise the dosage of the PPI or suggest twice-daily administration to enhance its effectiveness, as recommended in a review published in the Journal of the American Academy of Dermatology.
2. H2 Blocker
Another option is the addition of an H2 blocker, a type of medication that reduces stomach acid production by targeting histamine H2-receptors. According to the Mayo Clinic, H2 blockers can help alleviate symptoms.
3. Sucralfate
If an ulcer is present, your doctor may prescribe sucralfate, which belongs to a group of medications known as protectants. Sucralfate forms a protective coating over the ulcer, shielding it from acid exposure and facilitating healing, as outlined by the National Library of Medicine.
When to Talk to Your Doctor About Stomach Pain from Prednisone
If you're taking prednisone and your stomach hurts, it's important to let your regular doctor know right away. You don't have to put up with the pain because there are medicines that can help you feel better.
Sometimes, stomach pain caused by prednisone can be a sign of something more serious. So, it's best to talk to your doctor early on to make sure everything's okay and to find the right treatment. Usually, doctors don't want you to stay on prednisone for too long, so you can expect to stop taking it soon, and your stomach problems should improve too.
