Steroids for Crohn’s Disease: Uses, Side Effects, and More

Steroids for Crohn’s Disease: What to Know

Steroids for Crohn’s Disease: What to Know
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Published on September 3, 2025
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Steroids, also known as corticosteroids, are a common short-term treatment for Crohn's disease. They help alleviate inflammation and suppress an overactive immune system that can make Crohn’s symptoms worse.

“Short courses of steroids are typically given to patients with Crohn's disease who have symptoms from active intestinal inflammation,” says Jill Gaidos, MD, a gastroenterologist at Yale Medicine in New Haven, Connecticut.

But steroids also come with side effects that get worse the longer you take them. “Steroids aren’t a long-term fix for Crohn’s disease, but they can be a powerful tool in the right situation,” says Joseph Sleiman, MD, a gastroenterologist at Cleveland Clinic in Ohio.

Here’s what you should know about steroids for Crohn’s disease.

Steroids for Crohn’s Disease: How They Can Help

Although steroids don’t work well as maintenance therapies for Crohn’s, like biologics, they can be useful in a few different scenarios. “Think of steroids as the emergency team that puts out the fire, while we prepare a longer-term plan to keep it from coming back,” says Dr. Sleiman.

Steroids stop your body from making chemicals that cause inflammation, and these drugs suppress the immune system, which can lessen inflammation even more. (In Crohn’s disease, the immune system is thought to mistakenly attack the digestive tract, leading to inflammation and other Crohn’s symptoms.)

Your provider may recommend steroids for Crohn’s disease in certain situations, such as:

  • You need rapid symptom control.
  • Other medications aren’t working.
  • You experience a Crohn’s flare.
  • Extra-intestinal manifestations appear (other parts of the body beyond the digestive tract are affected).
People with moderate to severe Crohn’s may need steroids to get symptoms under control fast, says Sandhya Shukla, MD, a gastroenterologist with Atlantic Coast Gastroenterology in Brick Township, New Jersey.

Steroids can serve as a bridge to help treat symptoms while people with Crohn’s are getting started on a long-term, steroid-free treatment, says Dr. Gaidos.

Types of Steroids for Crohn’s Disease

Different steroids for Crohn’s can target specific needs and even distinct areas of the colon (large intestine). Available options include:

  • prednisone (Deltasone)
  • budesonide (Entocort EC)
  • methylprednisolone (Solu-Medrol)

  • Hydrocortisone enemas or foams (Cortenema, Colocort, Cortifoam)

Prednisone and budesonide typically come as tablets you take by mouth.

 “Prednisone is a go-to option for more severe flare-ups and works throughout the body,” says Sleiman. But prednisone for Crohn’s can affect more than just the intestine — it reduces the immune system’s effectiveness throughout the body.

Budesonide, a newer option, targets the intestine and doesn’t affect other parts of the body as much as prednisone, says Dr. Shukla. Budesonide doesn't always work as well as prednisone, but it has fewer side effects.

“Some patients respond to budesonide, while others respond better to prednisone. There are some patients who don't respond to oral steroids at all and have to be admitted to the hospital for intravenous steroids,” says Gaidos.

If oral steroids aren’t cutting it or if your flare is especially severe, you can get methylprednisolone through an IV in the hospital, says Sleiman. “Hydrocortisone enemas or foams are sometimes used for inflammation lower in the bowel, though that’s more common in ulcerative colitis than Crohn’s disease,” says Sleiman.

Side Effects of Steroids for Crohn’s Disease

Steroids can cause side effects, especially when taken longer than recommended. “Steroids can be lifesavers, but they do come with a price if used too long. This is why we try to taper [them] without waiting for any side effects,” says Sleiman.

Side effects of steroids can include:

  • Sudden weight gain
  • Facial fat increase (also known as “moon face”)
  • Mood changes
  • Trouble sleeping
  • High blood sugar
  • Skin thinning
  • Frequent infections
  • Weakened bones and muscles
  • Vision problems
  • High blood pressure and cholesterol
  • Inflamed or upset stomach
Long-term use can be associated with increased risk of infections as well as osteoporosis.

“If we start to see these issues, we work to taper the medication down and switch to safer, longer-term treatments,” says Sleiman.

Duration of Steroids

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.

The Takeaway

  • Steroids for Crohn’s disease treat symptoms fast, and include options like prednisone (Deltasone), budesonide (Entocort EC), and methylprednisolone (Solu-Medrol).
  • All steroid types can only be used for short periods because of potential side effects like sudden weight gain, bone and muscle weakness, mood changes, and high blood sugar, blood pressure, and cholesterol.
  • Everyone reacts differently to steroids, but your healthcare provider will help you customize a treatment plan to maximize benefit and minimize negative effects.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Hodgens A et al. Corticosteroids. StatPearls. May 1, 2023.
  2. Treatment for Crohn’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. July 2024.
  3. Medication Options for Crohn’s Disease. The Crohn's & Colitis Foundation.
  4. Cushing K et al. Management of Crohn Disease: A Review. JAMA. 2021.
  5. Blackwell J et al. Steroid Use and Misuse: A Key Performance Indicator in the Management of IBD. Frontline Gastroenterology. 2020.
  6. Feuerstein JD et al. Appropriate Use and Complications of Corticosteroids in Inflammatory Bowel Disease: A Comprehensive Review. Clinical Gastroenterology and Hepatology. 2025.
  7. Hydrocortisone Rectal Enema. Cleveland Clinic. 2025.
  8. Crohn's Disease - Diagnosis & Treatment. Mayo Clinic. October 29, 2024.
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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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