Steriod Treatment for Inflammatory Bowel Disease
Steroids are a group of medicines that are used to reduce inflammation and the activity of the immune system. They are also naturally produced in the body but are made as medication to treat flare-ups of inflammation as they are fast acting and allow the lining of the bowel wall to heal. The steroids used in IBD are hydrocortisone, prednisolone and sometimes budesonide.
Hydrocortisone is given by a drip in the hospital for 3-5 days to treat acute flare-ups
Prednisolone is given by tablet form for at least 8 weeks starting on a high dose and the dose is gradually reduced weekly over the 8 weeks.
Budesonide is used in Crohn's disease and can be given for at least 3 months. It is also given in tablet form. For ulcerative colitis it is used as a foam applied rectally.
When are steroids used?
Steroids are used to treat active disease or a flare-up. They are prescribed to control your symptoms and induce remission. In the majority of cases symptoms improve within days to weeks. The starting dose is usually high and gradually reduced and eventually stopped. They should not be continued long term because of the risk of side-effects.
What are the side-effects?
All medications have side-effects.
Possible short term side-effects include;
- Facial acne / facial hair
- Increased appetite
- Weight gain
- Swelling of face, hands and / or feet
- Mood swings such as irritability, anxiety, insomnia or very energetic
Long terms side-effects include:
- Thinning of bones
- Increased risk of infection
- Weight gain
- Muscle cramps / stiffness
- High blood pressure
- Stomach ulcers
- Damage to eyes
You will be prescribed a calcium/vitamin D supplement for the duration of your steroid treatment which will help protect your bones against bone thinning.
What should I do if I am experiencing side effects?
You may experience some, none, or all of the side effects. If in doubt contact your GP or nurse specialist as you may have to stop the treatment.
DO NOT STOP treatment abruptly unless medically advised. This is because the body needs to gradually adjust back to producing its own steroids.
Budesonide: If you have been prescribed Budesonide for Crohn's Disease you may experience little or no side effects as it works on the site of inflammation and only a small amount enters the blood steam.
What are the other steroid treatments?
Steroid treatments may also be given in the form of suppositories, enemas or foams to treat active inflammation in the back passage or lower bowel. The side effects are much reduced when taken this way.
POINTS TO REMEMBER
- Steroids are effective and quick at treating a flare-up of inflammatory bowel disease
- It is advisable to take your tablets in the morning
- Swallow whole, do not chew or crush
- Take after food
- You may experience side-effects
- Seek advice promptly from GP or specialist nurse if you experience side-effects
Prolonged use of steroids increases your risk of serious infection.
If you become unwell or if you are in direct contact with other persons with infections please contact your GP promptly. If you have not had chicken pox and come into contact with chicken pox or shingles please contact your GP for further advice. Inform your GP or dentist that you have had a course of steroids within one year of completion the course.