Corticosteroids

Glucocorticosteroids have long been first-line treatment to induce remission in Crohn disease and ulcerative colitis in children and adults.Common side effects affecting a range of body functions, occurrence of steroid dependency, as well as current treatment strategies involving early use of corticosteroid-sparing drugs (such as immunomodulators and biologicals) have made corticosteroids less and less popular. The current trend is to minimize or even avoid corticosteroid use in pediatric as well as adult inflammatory bowel disease (IBD). Budesonide, a topical corticosteroid that has a 90 % first-pass effect, can be used both as enteric coated capsule and as enema for specific indications. In this chapter, the working mechanism, efficacy, side effects and pharmacokinetics of “classic” (systemic) as well as topical corticosteroids such as budesonide will be reviewed.

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