Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that causes inflammation and sores, known as ulcers, in the large intestine. It occurs when an overactive immune system attacks the colon, causing it to become inflamed.

While the only known cure is a total proctocolectomy, or total removal of the colon, rectum, and anus, one line of treatment for UC is steroids.

Here, we’ll talk about how steroids can provide some relief from UC.

Inflammation in the colon and intestines, caused by an overly alert immune system, is what produces the pain and other symptoms of UC. By inhibiting your natural immune response, steroids are able to reduce this swelling and other UC symptoms.

A doctor may prescribe steroids (sometimes called corticosteroids) for the treatment of UC, though they are usually a short-term solution to treat active flare-ups.

How quickly do steroids work for UC?

The exact timeline for relief will depend on the steroid you are given and its method of dosage. However, you should notice some improvement in your condition within 3 to 5 days.

Even if you are not seeing the results you expect, do not discontinue steroid use unless your doctor recommends it.

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There are several types of steroids for UC. Some are oral and some are rectal. Below, you’ll find more detail on some of the more commonly prescribed steroids for UC:

  • Prednisone (Deltasone). This is a pill taken once daily, typically in the morning. Prednisone has been used for over 60 years and may also be prescribed at a high dose intravenously (through a vein).
  • Budesonide (Entocort EC). This steroid, taken in pill form, is quickly metabolized by the liver, which may reduce side effects.
  • Budesonide MMX (Uceris). These are extended relief tablets for active and mild to moderate UC.
  • Rectal hydrocortisone. This suppository may be recommended to treat UC or swelling.

Because there are several types of steroids, and everyone will have a different reaction to them, it’s important to have a good relationship with your doctor during your UC treatment.

Long before having you start steroids, your doctor will be able to plan out tapering regimens that will work best for you and escalate or de-escalate your treatment depending on your body’s needs.

Are steroids for UC covered under insurance or Medicare?

Most steroids are covered by insurance or Medicare, though they may only be available in generic form. Talk with a doctor or pharmacist to see what may be covered by your plan if you have one.

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Like most medications, steroids can have side effects, including:

Steroids lower the immune response, which in turn stops the body from attacking its own digestive system. When taking steroids, remember that because your natural immune response is lowered, it’s easier for you to get sick.

When to talk with a doctor

Talk with a doctor if your UC symptoms are not improving or responding to treatment. Seek medical care if you:

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Steroids are rarely prescribed for long-term use, so other treatments for UC will likely be needed. In some cases, UC is steroid-resistant. Other options for managing UC include:

  • Dietary changes: avoiding alcohol, processed foods, and dairy
  • Biologic drugs: adalimumab (Humira) or infliximab (Remicade)
  • Janus kinase (JAK) inhibitors: tofacitinib (Xeljanz)
  • Antibiotics: ciprofloxacin (Cipro), metronidazole (Flagyl), or rifaximin (Xifaxan)
  • Herbs and supplements: ginseng, probiotics, turmeric, and psyllium husk to ease symptoms

While symptoms of UC can go into remission, usually UC will flare up again because there is no permanent cure for the condition. The temporary use of oral or rectal steroids can help to suppress the immune response that causes flare-ups.

Steroids can only be used for short periods of time and are usually paired with other UC treatment options, like antibiotics, dietary changes, or supplements.