Are steroids used too much for patients with inflammatory bowel disease?

Steroid therapy is commonly used to treat acute attacks of the inflammatory bowel diseases ulcerative colitis and Crohn's disease; however, because it does not provide long-term benefits and it carries a risk of serious side effects, it should not be used to treat inflammatory bowel disease for more than three months.

In a large study published in Alimentary Pharmacology and Therapeutics, researchers at 19 centres in the UK report that, among 2,385 patients with inflammatory bowel disease, 14.8% showed evidence of steroid excess or dependency, and the steroid excess was judged avoidable in over 50% of cases.

The seven centres that had participated in a quality improvement programme had significantly fewer patients (11.5% versus 17.1%) receiving excess steroids.

"Looking at steroid prescribing for inflammatory bowel disease and trying to reduce steroid excess can be a powerful way to improve patient care and outcomes," said lead author Christian P. Selinger, MD, MSc, MRCP, of St. James University Hospital.