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Side effects of corticosteroid therapy.

A L Buchman1

  • 1Division of Gastroenterology and Hepatology, Northwestern University Medical School, Chicago, Illinois 60611, USA. a-buchman@northwestern.edu

Journal of Clinical Gastroenterology
|October 6, 2001
PubMed
Summary

Corticosteroids are effective for inflammatory bowel disease but carry risks. Short-term use has mild side effects, while long-term use can lead to serious, irreversible health problems.

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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.

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