Review article: older systemic and newer topical glucocorticosteroids and the gastrointestinal tract

Systemic steroids have been used in gastrointestinal disorders, such as ulcerative colitis and Crohn's disease. However, glucocorticosteroids are associated with potentially serious adverse effects. For that reason there is a search for a steroid which would have rapid first-pass metabolism in the intestine and liver, low systemic bioavailability, high topical activity and rapid excretion. This review will consider the absorption, transport, metabolism, mechanisms of action, general effects and effects of steroids on the intestine, and the new steroids in particular.