How Do Steroids Help with IBD Recovery? – and Are They Safe?

How Do Steroids Help IBD? – For Those That Are Curious!

Steroids are commonly used in the treatment of IBD. They help; suppress the immune system, reduce inflammation, and help heal inflamed sections of the bowel.

These medications are typically utilised when symptoms are severe or other treatments have failed to bring relief.

Steroids used in IBD treatment encompass a range of drugs, including Prednisolone, Hydrocortisone, and Budesonide. Prednisolone is commonly used for those with moderate-severe IBD and works quickly to control inflammation. Budesonide is primarily used for Crohn’s disease affecting the ileum and right side of the colon.

These steroids may be taken orally, administered rectally, or given via injection, depending on the individual’s condition. But, are they really the best thing for managing this condition?

The Benefits and Drawbacks of Steroids in IBD Treatment

While Steroids can provide rapid relief from severe IBD symptoms and are capable of inducing remission, they also carry potential risks and side effects.

Benefits of these drugs include;

• Swift Reduction in Inflammation,
• Relief of Pain, and
• The Reduction of Frequent Bowel Movements.

This swift action can often improve the quality of life dramatically for those suffering from severe IBD. However, drawbacks of long-term steroid use include increased susceptibility to infection, osteoporosis, weight gain, mood fluctuations, high blood pressure, and glucose intolerance, among other things.

They are generally not used as a long-term solution for IBD due to these potential side effects, and patients are usually transitioned to other treatments after the IBD has been brought under control.

Effectiveness and Side-effects of Steroids for IBD

Efficacy of Steroids in IBD Management

Steroids are frequently employed in the treatment of different types of Inflammatory Bowel Disease (IBD), including Crohn’s disease and ulcerative colitis. The way they work is by lessening Inflammation and suppressing the immune system, providing notable relief from symptoms such as diarrhoea, abdominal discomfort, and fatigue.

Steroids are typically used at the onset of treatment or during periods of severe flare-ups. Research has shown Steroids to be effective at inducing remission in roughly 50-70% of patients, with up to 30% experiencing a long-term remission of their IBD. [R}

Potential Side-Effects and Risks

Although Steroids can be highly effective in treating IBD, they also come with numerous potential side-effects and risks, which can be more severe with long-term use. These include suppression of the adrenal gland’s natural steroid production, which can lead to dependence and difficulties in ceasing steroid therapy.

Other side-effects can include bone thinning, increased susceptibility to infections, weight gain, mood and behavioural changes, and, in rare cases, damage to the eyes.

The long-term use of steroids can also lead to Cushing’s syndrome, characterized by a round ‘moon’ face, increased hair growth and thinning of the skin.

More serious complications can occur if Steroids are not managed correctly, such as adrenal insufficiency, which can cause fatigue, body aches and light-headedness, and in severe cases, can be life-threatening.

Steroid Sparing Strategy

Given the potential side-effects and risks of long-term Steroid use, many clinicians adopt a ‘steroid sparing’ strategy. This involves using a combination of different medications to limit the need for steroids. The most common steroid-sparing medications are thiopurines and methotrexate. [R]

Swapping to these medications might help patients to manage their IBD without experiencing the negative side-effects linked to long-term steroid use.

In Summary

Steroids can indeed be a potent initial course of treatment for IBD, nevertheless, their prolonged consumption might be linked to severe side-effects and complications. For this reason, it’s imperative that each patient’s medication and respective dosages are evaluated on a case by case basis, weighing the potential benefits against the risk factors, whilst consistently being monitored by medical professionals.

It’s also advisable to explore other treatment options to mitigate the requirement for extended steroid use.

Biologics

Biologics target specific proteins in the body that are part of the immune response. They work by blocking these proteins and thus prevent inflammation. Biologics are often recommended in moderate to severe cases of IBD where other treatments have not been successful.

Examples of biologics include adalimumab (Humira), infliximab (Remicade), vedolizumab (Entyvio) and ustekinumab (Stelara).

Side effects can include increased susceptibility to infection, reactivation of tuberculosis, and a rare chance of developing certain types of cancers.

Surgery

Surgery might be considered, often as a last resort, in severe cases of IBD where medication has not been successful. Surgeries mainly aim to remove damaged portions of the digestive tract. Types of surgeries depend on the type of IBD; for Crohn’s disease, it could be strictureplasty or resection, whilst for ulcerative colitis, it could be proctocolectomy with ileal pouch-anal anastomosis (IPAA).

Red Light Therapy For IBD Suffers

On this note of alternatives to steroids for IBD sufferers something else I covered in another article recently is Red Light Therapy.

Red light therapy (RLT) is an emerging alternative treatment that has shown promise for individuals suffering from Inflammatory Bowel Disease (IBD). This non-invasive therapy uses low-level wavelengths of red and near-infrared light to penetrate the skin and promote cellular regeneration and repair.

While it is more commonly associated with skincare and pain relief, growing evidence suggests it may benefit gut health.

How Does Red Light Therapy Work for IBD?

The effectiveness of RLT for IBD is believed to stem from its anti-inflammatory properties. By targeting the mitochondria in cells, red light stimulates energy production (ATP), enhancing the body’s natural healing mechanisms. For IBD sufferers, this can translate to reduced intestinal inflammation and improved gut lining repair.

Benefits of Red Light Therapy for IBD

• Reduced Inflammation: Chronic inflammation is a hallmark of IBD. RLT helps modulate inflammatory markers, potentially providing relief from flare-ups.
• Pain Relief: Many IBD patients experience abdominal pain. RLT may alleviate this discomfort by improving blood circulation and reducing tissue sensitivity.
• Improved Gut Barrier Function: Research suggests that RLT can promote the integrity of the intestinal lining, which may help reduce symptoms like diarrhea and cramping.
• Stress Reduction: Stress is a common trigger for IBD symptoms. The calming effects of RLT on the nervous system could indirectly improve gut health.

Practical Applications

While clinical-grade devices are often required for medical conditions, some home-use red light panels and handheld devices may be effective. For IBD, RLT can be applied to the abdomen or other affected areas, following manufacturer guidelines.

Sessions typically last 10–20 minutes and can be performed several times a week.

Current Research

Though promising, RLT is still in the early stages of being studied for IBD specifically. Preliminary studies and anecdotal reports highlight its potential, but more robust clinical trials are needed to establish standardized treatment protocols.

*Note – Before incorporating red light therapy into your routine, it’s important to consult your healthcare provider, especially if you’re undergoing conventional IBD treatments like steroids. RLT could complement existing therapies, offering a holistic approach to managing the condition.