Everything you need to know about steroids

A fast treatment for flare-ups of the disease, not for long-term use

• Fast-acting
• For a short time
• Stopped gradually

A powerful anti-inflammatory

What are steroids (corticosteroids)?

A medicine similar to a hormone the body makes naturally. It is used to calm flare-ups of the disease quickly, within days to weeks.

It helps control a flare, but it does not stop the disease coming back and is not used as a long-term treatment.

Forms of steroids

Forms

• Tablets by mouth — such as prednisolone; this is the most commonly used form
• Locally acting steroids — such as budesonide; it works inside the bowel with fewer side effects and suits specific situations
• Into a vein in hospital — for severe flares of colitis
• Suppositories or enemas — for inflammation of the rectum and the last part of the colon

Never stop them suddenly

Stopping gradually

Steroids are reduced gradually according to a schedule set by your doctor, because the body needs time to start making its own natural hormone again.

Stopping suddenly after taking them for weeks can cause severe tiredness and a drop in blood pressure.

Possible side effects

Side effects

• Disturbed sleep and mood
• Increased appetite and weight
• Raised blood sugar and blood pressure
• Thinning of the bones (osteoporosis)
• Eye problems — such as cataracts and glaucoma
• Higher risk of infection

Side effects increase with higher doses and longer use, and they vary from person to person.

How to protect yourself during treatment

Practical tips

• Take them in the morning with food — to reduce sleep problems and stomach irritation
• Calcium and vitamin D — as recommended by your doctor, to protect your bones
• Monitor blood sugar and blood pressure — especially if you have diabetes or high blood pressure
• Do not miss any dose — if you have vomiting, severe diarrhoea or a fever and cannot take it, contact your doctor straight away, as you may need an extra dose
• Tell any doctor who treats you — that you are taking steroids or have taken them in the past year, and carry a steroid card if you have one

Needing steroids again and again is a warning sign

An important sign

If you need steroids more than once a year, or your symptoms come back whenever the dose is reduced, this means your treatment plan needs adjusting.

Today there are treatments that keep the disease calm and reduce the need for steroids.

Steroids: the summary

Key messages

• A fast treatment for flare-ups of the disease
• Not used to keep the disease calm in the long term
• Reduced gradually and never stopped suddenly
• Watch for side effects and protect your bones
• Needing them repeatedly means the plan should be reviewed

Contact the clinic if you have:

• Symptoms coming back while the dose is being reduced
• Severely disturbed sleep or mood
• Blurred vision
• Raised blood sugar or blood pressure
• Symptoms of infection or a fever
• Run out of medicine before your appointment

If you faint, have persistent vomiting or severe tiredness while on steroids, while reducing them, or shortly after stopping them, go straight to the nearest emergency department.