Side effects of corticosteroid therapy.

Area of Science:

• Gastroenterology and Endocrinology
• Pharmacology of Anti-inflammatory Agents

Background:

• Corticosteroids have been a cornerstone in inflammatory bowel disease (IBD) treatment since the 1940s.
• While over 80% of patients show acute response, 20% may be refractory or develop dependence.
• Long-term corticosteroid use poses significant risks, mimicking Cushing's disease due to exogenous hypercortisolism.

Purpose of the Study:

• To comprehensively review the side effects associated with corticosteroid therapy in inflammatory bowel disease.
• To differentiate between acute and long-term adverse events.
• To inform clinical practice regarding the risks and benefits of corticosteroid use in IBD.

Main Methods:

• Literature review utilizing PubMed (1966-2000).
• Inclusion of author's personal manuscript and abstract files.
• Analysis of citations from known relevant references.

Main Results:

• Short-term corticosteroid use presents generally mild side effects: cutaneous, electrolyte imbalances, hypertension, hyperglycemia, pancreatitis, hematologic, immunologic, and neuropsychologic effects.
• Occasional clinically significant acute side effects can occur.
• Long-term corticosteroid use is linked to severe sequel: osteoporosis, aseptic necrosis, adrenal insufficiency, gastrointestinal, hepatic, ophthalmologic issues, hyperlipidemia, growth suppression, and potential congenital malformations.

Conclusions:

• Short-term corticosteroid therapy for IBD is associated with manageable side effects.
• Long-term corticosteroid administration carries substantial risks of serious and potentially irreversible complications.
• Careful monitoring and consideration of alternative therapies are crucial for patients requiring prolonged corticosteroid treatment.