I have an ileostomy and I'm currently medication free, apart from Loperamide and Folic Acid, have been for nearly 10 years, I'm due for J Pouch Surgery soon.
Is Prednisolone routinely prescribed/administered during or after J pouch surgery ?
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I wouldn't expect them to give you steroids if you're not already on them.
Folks who are on steroids chronically (steroid-dependent) need extra-high doses (stress doses) for surgery, because their adrenal glands are suppressed and won't respond appropriately to the stress of surgery.
Folks who are on steroids chronically (steroid-dependent) need extra-high doses (stress doses) for surgery, because their adrenal glands are suppressed and won't respond appropriately to the stress of surgery.
Yeah, that's my thinking too but I wondered whether administered after surgery to control inflammation ?
My surgeon said you have to stay away from steroids for about 1 year before you can have this surgery. And no, he would never prescribe steroids during the surgery, as it's a controindication (steroids can lead to abscess, infection and so on).
So I'd say you are definitely in the right track for surgery!
So I'd say you are definitely in the right track for surgery!
It all depends on how long and at what dose you were on previously. If you have been off steroids for a year or more, you would not need them during surgery. But, there is controversy about giving perioperative steroids in those who have stopped taking them 6-12 months before surgery.
After 10 years, I doubt you would get steroids.
The dosing is not to prevent inflammation, but to prevent dangerous shock during surgery. Cortisol is a stress hormone, and surgery is definitely stress on the body. Some people suffer adrenal suppression from long term steroids, and you actually do not know if you have it until your body is tested. Often, surgeons are risk adverse and would rather give you a couple of doses of hydrocortisone during surgery, than worry about shock in the middle of a procedure that could risk your life. But, there is some evidence that it is not necessary. I do know that I did have a hydrocortisone "booster" during my hernia repair, even though I waited a full year after tapering of prednisone, purely as a safety precaution.
This does not mean you will need oral steroids for any time after surgery. It is just to cover the needed surge during the surgery itself. Many people don't even know they got it.
Jan
After 10 years, I doubt you would get steroids.
The dosing is not to prevent inflammation, but to prevent dangerous shock during surgery. Cortisol is a stress hormone, and surgery is definitely stress on the body. Some people suffer adrenal suppression from long term steroids, and you actually do not know if you have it until your body is tested. Often, surgeons are risk adverse and would rather give you a couple of doses of hydrocortisone during surgery, than worry about shock in the middle of a procedure that could risk your life. But, there is some evidence that it is not necessary. I do know that I did have a hydrocortisone "booster" during my hernia repair, even though I waited a full year after tapering of prednisone, purely as a safety precaution.
This does not mean you will need oral steroids for any time after surgery. It is just to cover the needed surge during the surgery itself. Many people don't even know they got it.
Jan
Thanks for the very detailed replies.
Prior to the creation of my ileostomy whenever I had an UC flare up, I was prescribed oral Prednisolone, when this didn't work, I got IV steroids.
I believed such medication was administered to reduce the inflammation.
As I'm currently not prescribed medication to treat UC; after surgery I would rather remain so.
Prior to the creation of my ileostomy whenever I had an UC flare up, I was prescribed oral Prednisolone, when this didn't work, I got IV steroids.
I believed such medication was administered to reduce the inflammation.
As I'm currently not prescribed medication to treat UC; after surgery I would rather remain so.
You are correct. In those situations, it is used to reduce the inflammation. Since you do not currently have active inflammatory disease, you are not needing it.
It is just that steroid use during surgery is for a different purpose, AND it is ONLY for those with a history of long term steroid use.
I would rather never say never, though, because some people do indeed require steroids after surgery with their j-pouch. But, that is only after a long bout of pouchitis that is not responsive to standard treatment, NOT to prevent inflammation.
Still, it is a good question to ponder and ask!
Jan
It is just that steroid use during surgery is for a different purpose, AND it is ONLY for those with a history of long term steroid use.
I would rather never say never, though, because some people do indeed require steroids after surgery with their j-pouch. But, that is only after a long bout of pouchitis that is not responsive to standard treatment, NOT to prevent inflammation.
Still, it is a good question to ponder and ask!
Jan