Corticosteroids (steroids) are powerful anti-inflammatory agents that are used only for active ulcerative colitis and Crohn's disease. They can be taken orally, intravenously, or rectally as a suppository, enema or foam. Steroids have serious long-term side effects and are not useful for maintenance therapy. Once the active disease has subsided, steroids must be withdrawn gradually in order to give the body time to recover its own ability to produce natural steroids. If the dosage is reduced too rapidly, withdrawal symptoms may occur, including fever, malaise, and joint pain. If this occurs, the dosage is increased slightly and maintained until the symptoms are gone. More gradual withdrawal is then resumed.
Prednisone, hydrocortisone, and methylprednisolone are the most common steroids. Newer steroids such as budesonide (Entocort) affect only local areas of the intestine and do not circulate throughout the body. This may avoid the side effects that are a serious problem with long-term treatment using the older steroids.
