What is the role of topical corticosteroids in the treatment of inflammatory bowel disease (IBD)?

Updated: Apr 10, 2020
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Topical corticosteroids are used in persons with distal colonic disease in a manner similar to that of topical mesalamine; the major difference is that even though topical mesalamine may be used to help maintain remission, topical corticosteroids are used for active disease and have only a small role in the maintenance of remission. According to AGA guidelines, topical therapy with either hydrocortisone (grade A recommendation) or budesonide (grade B recommendation) is effective for distal colonic inflammation in patients with mild to moderate IBD. [60]

Patients with ulcerative colitis with predominantly distal disease may be treated with topical budesonide, a synthetic steroid which has local anti-inflammatory effects and limited systemic effects. [93] Although topical budesonide is effective, novel oral controlled-release formulations have been developed to enable treatment of the entire colon. [93]

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