Corticosteroid Therapy for Ulcerative Colitis: Understanding the Side Effects

Corticosteroids are a common and effective treatment option for patients with ulcerative colitis. However, not every patient will require or benefit from steroid use. When used short-term, the side effects of steroids can generally be managed. Long-term usage, however, should always be supervised by an experienced physician to avoid misuse and potential complications.

Steroids can cause a wide range of side effects—not only in individuals with ulcerative colitis but in all patients who take them. These adverse effects vary depending on dosage and duration, and some may significantly impact quality of life.

One of the most visible effects is the redistribution of body fat, which can lead to a rounded face known as "moon face," or increased fat buildup between the shoulders, referred to as "buffalo hump." Patients may also notice thinning arms and legs, weight gain around the abdomen, acne, abnormal hair growth, and weakened bones that increase the risk of fractures.

For patients who already have impaired glucose metabolism, long-term corticosteroid therapy can worsen insulin resistance and potentially trigger the development of diabetes. This metabolic complication is a major concern for many physicians when considering steroid use.

Another critical issue is immunosuppression. Corticosteroids reduce the body's natural immune response, making patients more susceptible to infections. This includes rare bacterial or viral infections and other opportunistic illnesses that wouldn't typically affect someone with a healthy immune system.

Additionally, corticosteroids can cause fluid retention, leading to high blood pressure, swelling (edema), and sudden changes in body weight. Managing these symptoms often requires dietary adjustments and close monitoring by a healthcare provider.

In conclusion, while corticosteroids play a valuable role in controlling inflammation and flare-ups in ulcerative colitis, patients must work closely with their doctors to weigh the benefits against the risks, especially when long-term treatment is necessary.