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Corticosteroids for Inflammatory Bowel Disease

Corticosteroids for Inflammatory Bowel Disease

Examples

Generic Name Brand Name
budesonide Entocort
dexamethasone  
hydrocortisone Cortef, Cortenema, Proctofoam
methylprednisolone  
prednisolone Orapred
prednisone  

Some of these medicines may be taken as pills. If the disease affects only the lower part of the colon, corticosteroids can be given by enema. For disease that only affects the rectum, suppositories and topical creams can be used. In severe cases, some corticosteroids are given through a needle in a vein (IV).

How It Works

These medicines reduce inflammation.

Why It Is Used

Corticosteroids are used to treat ulcerative colitis and Crohn's disease ( inflammatory bowel disease, or IBD ).

Ulcerative colitis

  • Corticosteroid pills are used to stop symptoms of moderate to severe ulcerative colitis when aminosalicylates, such as sulfasalazine or mesalamine, have not worked.
  • Corticosteroid enemas, suppositories, creams, or foam can be used to treat mild to moderate ulcerative colitis that is limited to the rectum or lower part of the colon.
  • Severe extensive disease sometimes requires treatment with intravenous (IV) corticosteroids.

Crohn's disease

  • Corticosteroid pills are used to stop symptoms of moderate to severe Crohn's disease. They are used when other medicines have not worked to stop a flare-up of Crohn's disease.
  • More severe symptoms of Crohn's disease may need to be treated with corticosteroids given in a vein (intravenous, or IV). This is usually done in the hospital.

How Well It Works

Corticosteroids improve or stop the symptoms of ulcerative colitis and Crohn's disease. These medicines are used to put the disease in remission (a period without symptoms). They are not used long term. When the disease has gone into remission, your doctor will gradually reduce the strength and the amount of corticosteroid you are taking.

Only people who do not get better with other medicines—less than half of people with IBD—need to take corticosteroids. Of these people, many go into remission after taking corticosteroids. 1, 2 Some people with IBD may need to keep taking a small dose of corticosteroids to help keep them in remission.

Steroid enemas may be especially helpful for inflammation in the lower colon and the rectum.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Signs of an infection, such as a sore throat, fever, sneezing, or coughing.
  • Belly pain, nausea, or vomiting that won't go away.
  • Bloody or black, tarry stools.
  • Rapid weight gain.
  • Changes in your eyes, including blurred vision or eye pain.
  • Muscle cramps, pain, or weakness.
  • Changes in skin, including acne or reddish purple lines.
  • Increased thirst, especially with frequent urination.

Common side effects of this medicine include:

  • Increased appetite.
  • Nervousness or restlessness.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Corticosteroids can keep your immune system from fighting infection. When you are taking this medicine (and even when you have finished taking it), try not to be around people who are sick. And make sure you talk to your doctor before you get any vaccinations.

People who take corticosteroids for more than 2 to 3 months should take calcium and vitamin D supplements or other medicines, such as bisphosphonates, to prevent osteoporosis. For more information, see the Medications section of the topic Osteoporosis. Your doctor may want you to have a bone density test to check for osteoporosis.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Mills SC, et al. (2011). Crohn's disease, search date December 2009. BMJ Clinical Evidence . Available online: http://www.clinicalevidence.com.
  2. Friedman S, Lichtenstein GR (2006). Ulcerative colitis. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 803–817. Philadelphia: Saunders Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Arvydas D. Vanagunas, MD - Gastroenterology
Last Revised October 8, 2012

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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