How Do Rectal Corticosteroids Work?

Rectal corticosteroids are a class of medications used to control active mild to moderate ulcerative colitis (a chronic, inflammatory bowel disease that causes inflammation in the digestive tract). The most common symptoms when the disease flares up are diarrhea mixed with blood and abdominal pain. Rectal corticosteroids do not cure ulcerative colitis; however, if these patches are confined to the lower parts of the bowel (rectum), rectal preparations (enema or foam) help to treat the discomfort during flare-ups. They help to reduce symptoms by calming the inflammation in the delicate mucosal layer of the bowel.

Rectal corticosteroids are used as foams in the rectum (2 mg/metered dose), usually in the morning and evening for the first 2 weeks, then once a day in the evening for the next 4 weeks. It is best to use this medication just before bedtime in the evening.

They work in the following ways:

• Anti-inflammatory steroids are released whenever the body experiences stress, disease, or trauma. They interact with the DNA in the cell to produce proteins called “lipocortin”, and these proteins, in turn, block the chemical called “arachidonic acid” necessary for inflammatory response, leading to reduced inflammation.
• Vasoconstriction (constriction of the blood vessels)-Inflammation leads to dilatation of the blood vessels around the infected site; corticosteroids constrict the capillaries (smallest blood vessels) and reduce swelling and pain.

Rectal corticosteroids are indicated for the induction of remission in patients with active mild to moderate distal ulcerative colitis.

Common side effects include:

• Nausea
• Decreased blood cortisol levels
• Other rare side effects include:
• Insomnia
• Adrenal insufficiency (tiredness, nausea, vomiting, weakness, and low blood pressure)
• Mood swings
• Hypercorticism characterized by
• Acne
• Bruising easily
• Rounded face (moon face)
• Swelling of ankles
• Thicker hair growth on the body and face
• Fatty pad or hump between the shoulders (buffalo hump)
• Pink or purple stretch marks on abdomen, thighs, breasts, and arms

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Drug names include:

• Budesonide rectal
• Uceris rectal foam