Crohn’s disease is an inflammatory bowel disease that affects the gastrointestinal tract. The condition is characterized by periods of remission and flare-ups. Flare-ups may occur at any time and last anywhere from hours to months.
Common symptoms that occur during a flare-up may include abdominal pain and diarrhea. In order to help manage these symptoms, steroids are often prescribed with the aim of reducing inflammation.
Forms of corticosteroids
Corticosteroids are synthetic drugs that resemble cortisol. Cortisol is a hormone produced in your adrenal glands in response to stress.
Corticosteroids are usually given to reduce swelling, itching, or allergic reactions. They may also relieve symptoms of Crohn’s disease.
This medication is available in three forms:
Oral corticosteroids enter directly into your bloodstream. They target your entire body rather than a specific area. They are generally prescribed for short-term use to ease symptoms during a flare-up.
This option comes in pill form and is usually taken for 4 to 8 weeks. Your doctor will then gradually reduce the dose.
A calcium supplement will often be prescribed, too. The addition of calcium may help reduce the risks of osteoporosis that come with long-term oral corticosteroid use.
Controlled-release corticosteroids are also taken orally. They are focused on the ileum, or the bottom part of your small intestine and ascending colon.
Steroid enemas may be particularly effective because they deliver treatment directly to the inflamed area.
Corticosteroid enemas are usually foam-based and treat your colon, descending colon, or rectum. There is limited amount of the drug that enters the bloodstream. For severe symptoms, enemas may be prescribed along with oral corticosteroids.
Predfoam enemas are inserted into to your colon with a tube. This type of enema has a higher concentration of the active ingredient, but may be harder to tolerate.
The colifoam enema offers a lower concentration by may be easier to hold in the colon.
Types of corticosteroids
There are different types of corticosteroids and they include:
Prednisone is the most commonly prescribed corticosteroid. It is used to treat several conditions, such as asthma, allergies, multiple sclerosis, and multiple myeloma.
For Crohn’s, prednisone is usually taken orally, although may sometimes be injected. Prednisone can elevate your blood sugar levels, so it’s important to get your blood checked regularly while taking it.
Other side effects may include:
- water retention
- mania, more common in people with bipolar disorder
Also used to reduce inflammation, prednisolone is prescribed for everything from lupus to arthritis. Some people have allergic reactions to prednisolone, so it’s recommended to start taking it in small doses. Prednisolone may also weaken your immune system, making you susceptible to infections.
Hydrocortisone, another synthetic form of cortisol, suppresses your immune system in order to reduce a flare-up.
Hydrocortisone can come as a rectal cream, pill, enema, or IV.
Possible side effects of hydrocortisone include:
- weight gain
- bloody stools
- elevated blood pressure
If you experience side effects from this medication, your doctor may reduce your dosage to a more manageable level.
Budesonide works by reducing inflammation in your digestive tract. It’s usually used for mild to moderate cases of Crohn’s. However, it may also be prescribed to people whose symptoms are in remission. Some of the more severe side effects of budesonide include:
- difficulty breathing
- facial swelling
- white patches in your throat, mouth, or nose
- behavioral changes, although this is rare and usually applies to children
Crohn’s disease may be a challenging to manage. However, corticosteroids may be effective in reducing inflammation. Each corticosteroid has its own benefits, along with its own side effects. So, its important to consider with your doctor which treatment may be best for you.