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Side Effects of Corticosteroid Therapy

Buchman, Alan L. M.D., M.S.P.H.

Journal of Clinical Gastroenterology: October 2001 - Volume 33 - Issue 4 - pp 289-294
Clinical Reviews: Therapeutic Recommendations

Background: Corticosteroids have been used for the treatment of inflammatory bowel disease since the late 1940s. Upwards of 80% of patients may respond acutely to treatment with these medications, although 20% or more may be refractory and others become dependent on corticosteroid use to suppress disease activity. Side effects in the acute situation are relatively minor, although significant side effects (e.g., psychosis) have been encountered; the long-term use of corticosteroids is more problematic. This creates a milieu for the potential for serious and irreversible problems. These side effects are discussed in detail. The side effects from corticosteroids emulate from exogenous hypercortisolism, which is similar to the clinical syndrome of Cushing's disease.

Study: PubMed search for years 1966–2000, author's personal manuscript/abstract files, and citations of known references.

Conclusion: Short-term corticosteroid use is associated with generally mild side effects, including cutaneous effects, electrolyte abnormalities, hypertension, hyperglycemia, pancreatitis, hematologic, immunologic, and neuropsychologic effects, although occasionally, clinically significant side effects may occur. Long-term corticosteroid use may be associated with more serious sequale, including osteoporosis, aseptic joint necrosis, adrenal insufficiency, gastrointestinal, hepatic, and ophthalmologic effects, hyperlipidemia, growth suppression, and possible congenital malformations.

From the Division of Gastroenterology and Hepatology, Northwestern University Medical School, Chicago, Illinois, U.S.A.

Address correspondence and reprint requests to Dr. Alan L. Buchman, Division of Gastroenterology and Hepatology, Northwestern University Medical School, 676 North St. Clair Street, Suite 880, Chicago, IL 60611, U.S.A. E-mail: a-buchman@northwestern.edu

© 2001 Lippincott Williams & Wilkins, Inc.