Treatments for Ulcerative Colitis: Steroid Side Effects

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Corticosteroids and Ulcerative Colitis

If you are taking corticosteroids for ulcerative colitis, steroid side effects may be foremost on your mind. The body uses steroids naturally in order to suppress inflammation, but corticosteroids are given to people in much higher doses than those that the body naturally produces. Steroids are used in patients who have ulcerative colitis because they reduce inflammation in the colon, which can minimize ulcerative colitis symptoms.

Forms of Administration

Taking steroids for ulcerative colitis can have several negative side effects, but the form of administration greatly affects the chances of these side effects occurring. Corticosteroids can be taken orally or rectally, with oral steroids being the most likely to cause adverse side effects. When steroids are taken orally, they travel throughout the body and do not discriminate between the various parts of the body. That means what while oral steroids do affect the colon, they affect other parts of the body as well. The exception to this rule is controlled release oral steroids (e.g., Entocort), which is released in the ascending colon rather than throughout the body.

Steroid enemas, which are taken rectally, are released only in the descending colon. Although taking controlled release oral steroids and enemas can minimize side effects, they also treat only specific parts of the colon. Taken together, however, they can treat most of the colon effectively while still minimizing the chances of side effects.

Possible Side Effects of Steroids

Possible ulcerative colitis steroid side effects can be severe, including a heightened susceptibility to infection to due a supressed immune system, diabetes, and osteoporosis. It can also lead to hypertension, difficulty sleeping, eye problems such as cataracts and glaucoma, and irregular menstruation. Surprisingly, steroids used for ulcerative colitis can actually cause ulcers in the upper gastrointestinal tract. Personality changes are a common side effect of ulcerative colitis steroids, including increased irritability, psychosis, depression, and even suicidal thoughts. Less severe side effects include weight gain, acne, and excess hair growth.

Minimizing the Side Effects

You can minimize the chances of developing some of these side effects, especially if you follow your doctor’s instructions in taking the steroids. To avoid infection due to a supressed immune system, make sure you are up-to-date on your vaccinations, including flu shots, and call your doctor immediately if you develop a high fever, painful urination, skin boils, or a muccus-filled cough.

Taking the steroids after full meal will help reduce the chances of developing additional ulcers, and getting enough calcium and vitamin D is essential in minimizing your chances of developing osteoporosis. Taking your steroids in the morning (with your doctor’s approval) can help reduce sleeping issues, and eating a healthy diet for colitis that is low in sodium and relatively low in calories can ameliorate some of the other side effects, such as hypertension and weight gain.

References

https://www.ulcerativecolitis.org.uk/medications/steroids.htm

https://www.mayoclinic.com/health/steroids/HQ01431

https://www.hss.edu/conditions_reduce-corticosteroid-side-effects.asp

https://www.everydayhealth.com/blog/scientist-patient-looks-at-ibd-colitis/eliminating-side-effects-for-steroids/

https://health.nytimes.com/health/guides/disease/ulcerative-colitis/medications.html