Ulcerative colitis is a chronic inflammatory bowel disease that causes inflammation and sores in the large intestine. It happens when the immune system attacks the colon.

While the only known cure is a total proctocolectomy, or total removal of the colon, rectum, and anus, one line of treatment for UC is steroids.

We will discuss how steroids can help with UC.

The pain and other symptoms of UC are caused by inflammation in the colon and intestines. Steroids can reduce swelling and other UC symptoms by blocking your immune response.

A doctor may prescribe steroids (sometimes called corticosteroids) for the treatment of UC, though they are usually a short-term solution to treat active flare-ups.

How quickly do steroids work for UC?

The exact timeline for relief will depend on the steroid you are given and its method of dosage. However, you should notice some improvement in your condition within 3 to 5 days.

“If you don’t see the results you expect, don’t stop using steroids unless your doctor recommends it.”

There are several types of steroids for UC. Some are oral and some are rectal. Below, you’ll find more detail on some of the more commonly prescribed steroids for UC:

  • Prednisone (Deltasone). This is a pill taken once daily, typically in the morning. Prednisone has been used for over 60 years and may also be prescribed at a high dose intravenously (through a vein).
  • Budesonide (Entocort EC). This steroid, taken in pill form, is quickly metabolized by the liver, which may reduce side effects.
  • Budesonide MMX (Uceris). These are extended relief tablets for active and mild to moderate UC.
  • Rectal hydrocortisone. This suppository may be recommended to treat UC or swelling.

It is important to have a good relationship with your doctor because you will have different reactions to steroids.

Your doctor will be able to plan out a regimen that will work best for you and escalate or de-escalate your treatment if you need it.

Are steroids for UC covered under insurance or Medicare?

Most steroids are covered by insurance or Medicare, but they may only be available in generic form. If you have a plan, you should talk to a doctor or a pharmacy about what you can get.

Like most medications, steroids can have side effects, including:

Steroids lower the immune response and stop the body from attacking its own system. Steroids make it easier for you to get sick because your immune response is lowered.

When to talk with a doctor

If your UC symptoms are not responding to treatment, you should talk to a doctor. If you need medical care, seek it.

Steroids are rarely prescribed for long-term use, so other treatments for UC will likely be needed. In some cases, UC is steroid-resistant. Other options for managing UC include:

  • Dietary changes: avoiding alcohol, processed foods, and dairy
  • Biologic drugs: adalimumab (Humira) or infliximab (Remicade)
  • Janus kinase (JAK) inhibitors: tofacitinib (Xeljanz)
  • Antibiotics: ciprofloxacin (Cipro), metronidazole (Flagyl), or rifaximin (Xifaxan)
  • Herbs and supplements: ginseng, probiotics, turmeric, and psyllium husk to ease symptoms

While symptoms of UC can go into remission, usually UC will flare up again because there is no permanent cure for the condition. The temporary use of oral or rectal steroids can help to suppress the immune response that causes flare-ups.

Steroids can only be used for a short time and are usually used with other UC treatment options.