Q. Prednisolone is the only solution for my rectal bleeding. How long can I take it?

Answered by
Dr. Arbab Muhammad Kashif Khan
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 29, 2020 and last reviewed on: Feb 24, 2021

Hi doctor,

I am a 27-year-old male. For the past five years I have ulcerative colitis. My main problem is bleeding form rectum. When I take Prednisolone, I am fine for maximum of three months and after that again it starts bleeding and also continues with Mesacol. I also took Azathioprine (Aazoran) but those medicines cannot stop bleeding only Prednisolone is a solution for me what can I do and if I start taking Prednisolone again is that any problem? How many times in a year can I take Prednisolone? In five years, I took Prednisolone for 8-10 times. Please suggest solution.



Welcome to

Your history suggests that you have steroid-dependent ulcerative colitis. So you rightly started Azathioprine and I think it should work if you are taking a proper dose (you have not shared dose of Azoran and your body weight). You can take Azoran as 1.5-2.5 mg per kg body weight. Plus the dose of Mesacol is also low. Increase the dose to at least 2.4 gm/day and you can go up to 4.8 gm/day maximum.

Regarding frequency of steroid dosing, you can take it up to twice per year, in case of flare of your disease, but it will be better to avoid it if you have a better option (Azoran) because steroid has many long term adverse effects.

Investigations to be done:

Metabolite level of Azathioprine. Complete blood count. ESR (erythrocyte sedimentation rate).

Probable diagnosis:

Steroid dependant ulcerative colitis.

Treatment plan:

Tablet Mesacol (Mesalazine) 800 mg thrice a day. Adjust dose of Azoran according to metabolite levels.

Preventive measures:

Avoid NSAIDs (non-steroidal anti-inflammatory drugs).

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