Steroids, also known as corticosteroids, are a form of medication that can treat inflammation in the digestive tract due to ulcerative colitis (UC). A doctor may recommend steroids as a short-term treatment for UC flare-ups.

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Steroids help by quickly reducing inflammation in the digestive tract. A healthcare professional will typically prescribe them as a short-term treatment in the event of a flare up from UC.

They can work within a few days of use, and they assist in bringing flares under control and lead to remission.

Four out of five people with inflammatory bowel disease (IBD) may take steroids at some stage of their condition. IBD includes Crohn’s disease and UC.

For people with UC, healthcare professionals may prescribe oral or rectal steroids to treat flare-ups that do not require a hospital stay. Doctors may also recommend them in the event of a flare-up when the person cannot use aminosalicylates (5-ASAs).

In the event of acute severe UC, individuals may receive steroids intravenously in a hospital. Intravenous steroids typically work quickly and lead to improvement within a few days.

Most people see improvement in their symptoms with steroids. However, 20–30% of cases of acute symptoms of IBD will not respond to treatment with steroids.

The body naturally produces steroids, a type of chemical or hormone. Steroids that treat UC are a man-made version of the same hormone, but a person takes them at a higher dose than what their body naturally creates.

Higher doses of steroids lower the activity of the immune system, which helps reduce inflammation in the digestive tract.

Note that steroids for treating UC differ from the steroids used by some athletes to enhance performance. Those are known as anabolic steroids.

An individual can take steroids in a variety of ways. The method of treatment will depend on both the severity of the condition and location of UC symptoms.

Oral steroids

People most commonly take steroids for UC by mouth. Steroids taken orally may come as a tablet or capsule, or in dissolvable or liquid form.

Steroids that a person may take orally include:

  • Prednisone (Deltasone): A person takes this commonly prescribed form of steroids as a pill.
  • Budesonide (Entocort EC). The liver quickly metabolizes this medication, which reduces side effects and risks.
  • Budesonide-MMX (Uceris). Similar to budesonide, this medication has a coating that protects it until it reaches the colon. This allows more medication to reach the colon, which benefits people experiencing inflammation in that area.

Taking steroids orally in the morning will assist in reducing side effects.

Rectal steroids

When UC impacts the lower areas of the colon or the rectum, doctors may recommend a person take steroids via enemas or suppositories.

If a person takes steroids via an enema, an applicator contains the steroids as a liquid or foam. The individual inserts the applicator into the anus, where it reaches the colon. The applicator can they deliver the steroids.

Suppositories are capsules shaped like bullets that contain the steroids. A person can insert these via the anus to the rectum.

Steroids administered directly to the area of inflammation via suppositories or enemas have fewer side effects.

Steroids administered rectally include:

  • suppositories (hydrocortisone)
  • enemas (hydrocortisone, methylprednisone, Cortenema)
  • rectal foams (hydrocortisone acetate, proctofoam-HC, Uceris)

Like all medications, steroids come with potential side effects. Roughly 1 in 2 people taking steroids will experience side effects.

Steroids work by suppressing the immune system. Because of this, people taking steroids may be more susceptible to infections.

Some mild side effects may clear up on their own, while more serious ones may require treatment. It may also mean that person should not take steroids. For UC, a doctor will usually limit steroids to short periods to help reduce the likelihood of potential side effects.

Possible side effects can include:

  • high blood pressure
  • high blood sugar levels
  • cataracts
  • weight gain
  • acne
  • stretch marks
  • growth disruption in children
  • rounding of the face (referred to as “moon face”)
  • insomnia
  • increase in facial hair
  • mood swings
  • osteoporosis
  • psychosis
  • muscle and joint pain
  • muscle weakness
  • stomach pain
  • stomach ulcers
  • nausea

Despite possible side effects, a person should not suddenly stop taking steroids. If an individual has taken steroids for more than a few days, they will need to gradually reduce the dose over time rather than stopping suddenly.

When a person takes man-made steroids as a medication, the body stops making enough natural steroids that help the body function. Suddenly stopping steroid medication can affect blood sugar levels, cause blood pressure to drop, and lead to adrenal insufficiency (when the body doesn’t make enough hormones).

Steroids are not a long-term treatment option, due to possible side effects.

Doctors often prescribe steroids for people with UC on a short-term basis to help bring a flare-up under control and help the UC go into remission. A person may also take steroids on a short-term basis while waiting for other treatments to take effect.

Healthcare professionals often prescribe steroids for a period of 8 weeks, with the dose gradually reducing during this time. It is important a person completes the full course and does not stop taking steroids suddenly, even if symptoms improve.

Due to the possibility of numerous side effects, doctors often choose other medications before prescribing steroids for UC.

A person may try topical or oral 5-ASAs before trying steroids.

If a person and their doctor decide to reduce or stop taking steroids and symptoms continue, the individual may take immunosuppressants such as azathioprine (Azasan) or mercaptopurine (Purixan) along with steroids.

In cases of severe UC that does not improve with steroids or immunosuppressants, biological treatments like infliximab (Remicade) or adalimumab (Humira) may help.

Some FAQs about steroids and UC may include:

Do steroids help ulcerative colitis?

Steroids can be an effective treatment for UC, by helping to reduce inflammation in the digestive tract. Oral or rectal steroids can help treat a flare-up of UC. In more severe cases, a person may receive steroids intravenously.

How long does it take for steroids to help colitis?

Due to potential side effects, people will typically receive steroids on a short-term basis to help manage UC. Typically, a doctor will prescribe a course of steroids for roughly 8 weeks, with the dose gradually reducing during this time.

What is the drug of choice for ulcerative colitis?

In addition to corticosteroids, a doctor may also suggest medications such as 5-ASAs, immunomodulators, and biological treatments.

What happens if steroids do not work for ulcerative colitis?

If steroids are not effective, or a doctor decides to reduce steroids, they may recommend other treatments, such as immunosuppressants or biologics.

Steroids, also called corticosteroids, are medications that a doctor may prescribe to help treat UC.

Steroids work by suppressing the activity of the immune system, and in turn, lowering inflammation in the digestive tract to relieve symptoms during a flare-up.

A person should take these drugs only on a short-term basis, due to potential side effects.