A Special Kind of Steroid to Help with Crohn’s Disease

Crohn’s disease is a form of inflammatory bowel disease (IBD) that affects 1.6 million individuals in the United States. Many people experience symptoms like diarrhea, stomach pain, nausea, and even rectal bleeding. An overactive immune system is a leading cause of these symptoms. Steroids can help control these symptoms but cause undesired side effects. A formulation of oral budesonide, a type of steroid, comes in a multi matrix system that reduces steroid-related side effects. It is not absorbed by the body and works only in the gut. Individuals can live comfortably and experience fewer side effects compared to other steroids. Make sure to always contact your healthcare provider first before starting a new medication to determine if it is appropriate for you. 

Share This Post

About 1.6 million people are living with inflammatory bowel disease (IBD) in the United States. These individuals often have to deal with unpleasant symptoms, which leads to poor quality of life. 

Crohn’s disease is a type of IBD that affects a significant portion of the gastrointestinal (GI) tract. The GI tract has many different functions like digestion of food, absorption of nutrients from food, and elimination of waste. When an individual has Crohn’s disease, their GI tract may stop working correctly. 

Crohn’s disease accounts for about 50% of all IBD cases and leads to chronic irritation of the GI tract. 

The constant irritation of the GI tract can cause symptoms, like:

  • Persistent diarrhea
  • Abdominal pain
  • Rectal bleeding/bloody stools
  • Weight loss
  • Fatigue 

The causes of Crohn’s disease are not well understood. What is known is that a person’s genetics, environmental, and lifestyle triggers play a role in how symptoms start and then persist. We know the immune system becomes overactive and attacks your own GI tract, leading to symptoms.

Potential triggers that can cause Crohn’s disease: 

  • Smoking
  • Use of antibiotics
  • History of appendix removal
  • Non-steroidal anti-inflammatory (NSAID) drugs
    • Examples include ibuprofen and naproxen
    • Diet
    • Different foods can unpredictably affect individuals
    • There is no single diet that can be linked to Crohn’s disease and its flare-ups
    • Individuals should avoid foods which cause their flare-ups 
    • Some people have a gluten intolerance, known as celiac disease; this can lead to Crohn’s disease over time if celiac disease is untreated or gluten is not avoided

Individuals may experience this condition very differently and can have different symptoms. When there is a period without any symptoms, it means the disease went into remission. Medications and avoiding triggers may help move the condition into remission. On the other hand, When Crohn’s is active, it can be classified as mild, moderate, and severe. 

The good news is that about half of all individuals who do have Crohn’s are in remission thanks to proper medication use and trigger avoidance. 

Despite our poor understanding of what causes Crohn’s, we have a pretty good understanding of symptom management and the use of medications that put Crohn’s back into remission.  

Steroids for Crohn’s

Symptoms of Crohn’s disease result from an overactive immune system. Following this logic, it makes sense to suppress the immune response – to help control symptoms. 

Steroids are the classic medications used to suppress the immune system. They come in different types and formulations. 

One of the more common steroids that comes to mind is prednisone. While prednisone effectively controls symptoms of Crohn’s disease, it comes with many undesirable side effects. These side effects are common to all steroids because once they enter the bloodstream, they start working on many different parts of the body. 

Side effects of steroids include:

  • Acne
  • Rounding of the face 
  • Body hair growth
  • Mood swings 
  • Insomnia
  • Weight gain
  • Stretch marks
  • Hair loss

Budesonide

A reasonable question to ask is: how do we control symptoms of Crohn’s disease and, at the same time, avoid the side effects of steroids?

The answer comes in the form of a very particular formulation of oral budesonide dosed once a day. 

This form of budesonide, once ingested, moves along the GI tract and does not get absorbed by the body. It works on the surface of the GI tract and reduces inflammation in the gut. It is called a multi-matrix system. This system prevents budesonide from being absorbed into the body and thus minimizes side effects.

Oral multi matrix budesonide should not be used longer than 4 months. Ideally, it should not be taken for longer than 2 months if Crohn’s goes into remission. Once remission occurs, the dose can be reduced. It should also only be used to induce remission for mild and moderate Crohn’s disease. It should not be used in severe Crohn’s disease or once remission is achieved.

Budesonide works best if it is taken in the morning and can be taken with or without food.

Individuals tolerate this formulation of budesonide very well. Only about 20% of patients reported any side effects. The chances of developing side effects increase when budesonide is taken longer than recommended. A study looked at individuals with Crohn’s taking budesonide and found that no side-effects had developed within 2 months of treatment

Individuals are also able to maintain remission of Crohn’s for a long time thanks to budesonide. An 8-week course of oral budesonide was shown to prevent remission for up to a year in 50% of all patients. 

Compared to other steroids, oral budesonide is effective and, most importantly, leads to fewer side effects.

Bottom Line 

Crohn’s disease can be a debilitating condition if left untreated. Budesonide is an option for many individuals who have mild or moderate Crohn’s disease. 

The oral formulation of budesonide comes as a multi matrix system, which reduces typical steroid side effects. Budesonide is effective at putting Crohn’s into remission and can help many people live comfortably. 

This medication should be taken by mouth once daily as directed by your healthcare provider. If you think budesonide might be an option for you, make sure you speak with your primary healthcare provider first. 

Reference List

  • What is inflammatory bowel disease (IBD)? Centers for Disease Control and Prevention. Updated March 22, 2018. Accessed September 16, 2020. https://www.cdc.gov/ibd/what-is-IBD.htm
  • The Facts About Inflammatory Bowel Diseases. New York, NY: Crohn’s and Colitis Foundation of America; 2014. http://www.crohnscolitisfoundation.org/assets/pdfs/updatedibdfactbook.pdf
  • Crohn’s disease. Celiac Disease Foundation. Accessed September 16, 2020. https://celiac.org/about-celiac-disease/related-conditions/crohns-disease/
  • Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE. ACG Clinical Guideline: Management of Crohn’s Disease in Adults [published correction appears in Am J Gastroenterol. 2018 Jul;113(7):1101]. Am J Gastroenterol. 2018;113(4):481-517. doi:10.1038/ajg.2018.27
  • Benchimol EI, Seow CH, Otley AR, et al. Budesonide for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2009;(1): Cd002913
  • Magro F, Estevinho MM. Moving from efficacy to effectiveness: budesonide multimatrix in ulcerative colitis. United European Gastroenterol J. 2019;7(9):1153-1155. doi:10.1177/2050640619878588
  • Tursi A, Giorgetti GM, Brandimarte G, Elisei W. Safety and effectiveness of long-term budesonide treatment in maintaining remission in patients with mild-to-moderate Crohn’s disease. Inflamm Bowel Dis. 2007;13(9):1184-1186. doi:10.1002/ibd.20145
  • Tremaine WJ, Hanauer SB, Katz S, et al. Budesonide CIR capsules (once or twice daily divided-dose) in active Crohn’s disease: a randomized placebo-controlled study in the United States. Am J Gastroenterol. 2002;97(7):1748-1754. doi:10.1111/j.1572-0241.2002.05835.x
  • Campieri M, Ferguson A, Doe W, Persson T, Nilsson LG. Oral budesonide is as effective as oral prednisolone in active Crohn’s disease. The Global Budesonide Study Group. Gut. 1997;41(2):209-214. doi:10.1136/gut.41.2.209

We are committed to providing our readers with only trusted resources and science-based studies with regards to medication and health information. 

Disclaimer: This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you suspect medical problems or need medical help or advice, please talk with your healthcare professional.

Share This Post

Popular Destinations

Recent Articles

Everything You Need to Know About Food Poisoning

Food poisoning is an illness that occurs when food becomes contaminated with any number of bacteria, viruses, or parasites. Food can become contaminated during food preparation, food storage, or while being eaten. The symptoms of food poisoning are not always clear and may vary depending on the type of contaminant. Nevertheless, food poisoning often includes nausea, vomiting, and diarrhea. There are many different types of food poisoning which include chemical contamination (toxic substances), bacterial infection (salmonella), and parasitic infections (giardia). Please read on to learn more about food poisoning, its symptoms, and how to treat it.

Read More »

Celiac Disease: Symptoms, Complications, and Treatment

Triggered by gluten, celiac disease is a digestive disorder that causes damage to the small intestine.  There is a wide range of celiac disease symptoms, from digestive symptoms to seizures, fatigue, or anemia.  Someone with celiac disease has a greater risk of developing coronary heart disease and small bowel cancers.  Currently, the only treatment option for celiac disease is a gluten-free diet.  For questions or concerns about celiac disease or a gluten-free diet, reach out to your primary care provider. 

Read More »

Share On:

More To Explore

Everything You Need to Know About Food Poisoning

Food poisoning is an illness that occurs when food becomes contaminated with any number of bacteria, viruses, or parasites. Food can become contaminated during

Librax: What is it and What are the Side Effects?

Medications like Librax can help patients experiencing symptoms of IBS, but what is Librax and what are the side effects?

Librax: What is the Cost and Dosage?

Librax is a prescription medication that can help ease the symptoms of IBS for some patients. It should be stored at room temperature and

Celiac Disease: Symptoms, Complications, and Treatment

Triggered by gluten, celiac disease is a digestive disorder that causes damage to the small intestine.  There is a wide range of celiac disease

Nexium vs Prilosec: What’s the difference?

Nexium and Prilosec are both former prescription-only medications that are now sold at some strengths over the counter and offer relief for sufferers of

Omeprazole vs Esomeprazole: What’s the Difference?

Lansoprazole, Rabeprazole, Pantoprazole, Omeprazole and esomeprazole are some of the most popular drugs on the market for the treatment of GERD, but when comparing

What Is the Best Time of Day to Take Pantoprazole?

If you’ve ever been woken up by a burning feeling in your chest or felt that distinctive sour taste at the back of your

How Long Does it Take for Pantoprazole to Work?

What is Pantoprazole | Treatment Use | How does it work | How Long does it take to work | Cost | Side Effects Waking up in the middle of the night with a

What is Librax?

The most common gastrointestinal disorder you’ve never heard of is irritable bowel syndrome, or IBS. IBS is a common, chronic gastrointestinal condition that is

Steroids for Crohn’s Treatment

About 1.6 million people are living with inflammatory bowel disease (IBD) in the United States. These individuals often have to deal with unpleasant symptoms,

Reasons Green Poop: What Does Healthy, Normal, and Abnormal Mean?

Poop is a natural part of life, but the color can sometimes be alarming. What does a healthy poop look like? What causes green

Stomach Ulcers: What Causes Them, Symptoms and Treatment

A stomach ulcer is a sore or hole in the stomach lining and is also known as peptic ulcer disease. A stomach ulcer can

What Are The Side Effects Of Pantoprazole?

Acid reflux, and the range of health issues that cause it, affect a significant number of Americans – at least one in five adults

Do We Need a New Treatment for Constipation?

Millions of Americans suffer from a form of constipation called Chronic Idiopathic Constipation (CIC) every year. The American Journal of Managed Care defines CIC

Why is my stool yellow?

If your stool has turned yellow, you are not alone as many people experience yellow stool at some point in their lives. In most

Seed Probiotics Review: What Makes These Supplements Unique?

Seed offers their own proprietary blend of probiotics to help you restore gut health — but what makes their probiotics unique? Here we provide

The Gut Microbiome: How Does It Impact Your Health?

The truth is not all bacteria and viruses are harmful.  Your body is made up of trillions of microbes, and together they are known

Omeprazole vs Esomeprazole: What’s the Difference?

Lansoprazole, Rabeprazole, Pantoprazole, Omeprazole and esomeprazole are some of the most popular drugs on the market for the treatment of GERD, but when comparing

What Is Pantoprazole Used For?

First approved by the FDA for medical use in the USA in 2000, pantoprazole is part of a class of drugs known as PPIs,

Evens Review: What To Know About This Digestive Health Service

Evens is a telehealth company that provides treatment for gastrointestinal issues like acid reflux. In this article, we help you determine if it’s worth

Is Omeprazole an Antacid?

One of the most popular medications for the treatment of GERD is omeprazole, and people often wonder, “Is Omeprazole an antacid?”

Pepcid vs Zantac: What’s the difference?

Regardless of the type of medication used to treat GERD, the condition usually does not resolve without substantial lifestyle changes and dietary changes as

Nexium vs Prilosec: What’s the difference?

The International Foundation for Gastrointestinal Disorders estimates that anywhere from 15 to 30 percent of Americans suffer from gastroesophageal reflux disease, or GERD. GERD

What is Pantoprazole?

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) noted in a 2004 study that approximately one in five adults in America,

What is the Cost of Ranitidine?

Ranitidine is no longer available for sale either over the counter or by prescription since its recall by the FDA in April 2020. Prior