As mentioned, steroids can pack a punch in treating Crohn’s symptoms fast, but they shouldn’t be used for maintenance therapy. “Steroids are not good at keeping Crohn’s disease quiet in the long run — the symptoms often return once you stop. Plus, the more often you use them, the more likely side effects become,” says Sleiman.
Even after steroid side effects fade, Sleiman says he wouldn’t prescribe them again right away. “Our goal is to use them just long enough to get symptoms under control, then hand the job over to other treatments that can maintain remission without the same risks,” says Sleiman. However, if all other options have failed and the benefits of steroids outweigh the risks, a short course may be needed as a last resort, he says.
Doctors now have many other effective therapies to choose from, with a much better safety profile compared with steroids, says Shukla, who says she makes every effort to minimize the use of steroids with her patients.
Sleiman encourages his patients to think of steroids as a short-term backup plan, not their daily driver. “With the right strategy, steroids can be an important part of your care, but they should never be the whole story,” says Sleiman.
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