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Treatment for IBD has two main goals – to lessen the symptoms of active disease or a flare-up, and to maintain remission (a period of time where you have no symptoms and feel well).
Studies show that steroids help to control both active CD and active UC. But research shows steroids do not help to maintain remission. Steroids are therefore not used as long term maintenance therapy to prevent flare-ups. After achieving remission, you may need other medications, such as 5-ASA, azathioprine, or biologic therapy in order to stay in remission. For more information, see our drug information sheets. Steroids do not prevent IBD flares following surgery.
While steroids are good at healing inflamed bowel, they are not recommended for long term treatment due to their lack of effect in preventing flare-ups and their side effects (see Side effects). The aim for people with IBD is to reduce and stop steroids and move on to alternative treatments as soon as possible.
Oral steroids normally improve symptoms within one to four weeks, while intravenous steroids take four to 10 days. Around one in five people shows no response to steroid treatment (this is known as being steroid refractory). If your condition is not improving, contact your IBD team.
There are many reasons why steroids may not work including people not taking them as prescribed and genetic differences. It could also be that your symptoms are not caused by active IBD, but by a separate problem, such as underlying infections (Cytomegalovirus, Clostridium difficile), or another condition, such as irritable bowel syndrome (IBS) or lactose intolerance. If your symptoms are definitely being caused by inflammation, but are not responding to steroids, then your IBD team might suggest alternative treatments, such as biologic therapy or an immunosuppressant.
For more information, refer to the corresponding sections.
Copyright 2024 IBD Clinic.