Digestive tract intertwined with medicinal plants, symbolizing balance in IBD treatment.

Navigating IBD: Understanding Corticosteroid Use and Its Impact

Nico Varela in Health & Wellness December 2025 • 4 min read.

"A closer look at corticosteroid usage and its associated complications in inflammatory bowel disease (IBD) patients, offering insights for better management."

Inflammatory Bowel Disease (IBD), encompassing Crohn's disease and ulcerative colitis, presents a significant challenge for millions worldwide. While there is no cure, various medications aim to control inflammation and alleviate symptoms. Corticosteroids, powerful anti-inflammatory drugs, have long been a cornerstone of IBD treatment, particularly during flare-ups. However, their use is not without potential drawbacks.

A recent study published in PLOS ONE sheds light on the patterns of corticosteroid use and the associated complications within a large cohort of IBD patients in the United States. While the original study contained some inaccuracies that have since been corrected, the core findings remain relevant and provide valuable insights for both patients and healthcare providers.

This article delves into the key findings of the corrected study, highlighting the prevalence of corticosteroid use among IBD patients, the potential complications that can arise, and the ongoing efforts to optimize treatment strategies for improved long-term outcomes. It aims to empower IBD patients with a better understanding of their treatment options and the importance of informed decision-making.

Corticosteroids in IBD: A Double-Edged Sword

Digestive tract intertwined with medicinal plants, symbolizing balance in IBD treatment.

Corticosteroids, such as prednisone and budesonide, are synthetic drugs that mimic the effects of cortisol, a natural hormone produced by the adrenal glands. They work by suppressing the immune system, reducing inflammation, and alleviating symptoms such as abdominal pain, diarrhea, and rectal bleeding. Due to their rapid action and effectiveness, corticosteroids are often prescribed to induce remission during IBD flare-ups.

However, prolonged or repeated use of corticosteroids can lead to a range of adverse effects. These complications can affect various organ systems and significantly impact a patient's quality of life. Understanding these potential risks is crucial for both patients and healthcare providers to make informed decisions about treatment strategies.

Increased Risk of Infections: Corticosteroids suppress the immune system, making patients more susceptible to bacterial, viral, and fungal infections.
Bone Loss: Long-term use can lead to osteoporosis, increasing the risk of fractures.
Weight Gain and Fluid Retention: Corticosteroids can disrupt metabolism, leading to weight gain, swelling, and elevated blood pressure.
Mood Changes: Irritability, anxiety, depression, and even psychosis can occur as side effects of corticosteroid use.
Elevated Blood Sugar: Corticosteroids can increase blood sugar levels, potentially leading to or worsening diabetes.
Cataracts and Glaucoma: Prolonged use can increase the risk of developing these eye conditions.

The PLOS ONE study, even with its initial errors corrected, underscores the importance of carefully weighing the benefits and risks of corticosteroid therapy in IBD patients. The data reveals the prevalence of corticosteroid use and highlights the need for strategies to minimize exposure and mitigate potential complications.

The Path Forward: Optimizing IBD Management

Managing IBD effectively requires a multifaceted approach that goes beyond simply relying on corticosteroids. Newer treatment options, such as biologics and small molecule inhibitors, offer targeted therapies that can control inflammation with potentially fewer side effects. These medications are often used as steroid-sparing agents, helping patients reduce or eliminate their reliance on corticosteroids. Regular monitoring, proactive management of complications, and open communication between patients and healthcare providers are essential for achieving optimal outcomes in IBD.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0197341, Alternate LINK

Title: Correction: Corticosteroid Use And Complications In A Us Inflammatory Bowel Disease Cohort

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Akbar K. Waljee, Wyndy L. Wiitala, Shail Govani, Ryan Stidham, Sameer Saini, Jason Hou, Linda A. Feagins, Nabeel Khan, Chester B. Good, Sandeep Vijan, Peter D. R. Higgins

Published: 2018-05-09

Everything You Need To Know

What are corticosteroids and how do they work in treating IBD?

Corticosteroids, like prednisone and budesonide, are synthetic drugs that act like cortisol, a natural hormone. They reduce inflammation and alleviate IBD symptoms by suppressing the immune system. They are frequently used to quickly induce remission during flare-ups. However, while effective for rapid relief, corticosteroids don't cure IBD and can cause significant side effects with prolonged use.

What are the main risks or side effects of using corticosteroids long-term for IBD?

The risks associated with long-term or repeated Corticosteroid use includes an increased risk of infections because they suppress the immune system, making individuals more susceptible to bacterial, viral, and fungal infections. Bone loss leading to osteoporosis and increased fracture risk is also a major concern. Other complications include weight gain and fluid retention, mood changes, elevated blood sugar levels potentially leading to or worsening diabetes, and increased risk of cataracts and glaucoma.

What does the PLOS ONE study tell us about using corticosteroids for IBD?

The PLOS ONE study highlights the importance of carefully considering the benefits and risks of corticosteroid therapy in IBD. It reveals how frequently corticosteroids are used and emphasizes the need to minimize exposure to them due to their complications. The study underscores the need for alternative treatment strategies to reduce reliance on these medications.

What are 'steroid-sparing agents' and how do they help in IBD management?

Steroid-sparing agents, such as biologics and small molecule inhibitors, are newer treatment options designed to control inflammation with potentially fewer side effects than corticosteroids. These medications target specific components of the immune system involved in IBD, aiming to reduce inflammation without the broad immunosuppression caused by corticosteroids. Using these agents helps patients reduce or eliminate their reliance on corticosteroids, minimizing the risk of long-term complications.

Besides corticosteroids, what else is important in managing IBD effectively?

Effectively managing IBD goes beyond just using corticosteroids. It requires a comprehensive approach that includes regular monitoring, proactive complication management, and clear communication between patients and healthcare providers. While the text does not explicitly detail specific dietary or lifestyle adjustments, they are often a component of IBD management. Newer treatments, like those mentioned above, are also important for long-term management.