By Dr Pranab Gyawali, Consultant Gastroenterologist
Why You Shouldn’t Stay Stuck on Steroids for Crohn’s or Colitis – A Gastroenterologist’s View (Dubai)
If you’re living with Crohn’s disease or ulcerative colitis in Dubai, and you find yourself using steroids like prednisone again and again to control flares — it’s time to rethink your treatment.
As a consultant gastroenterologist with over 25 years of experience managing IBD, I’ve seen it all — and I can tell you this with confidence:
More patients suffer long-term complications from steroids than from biologics.
The Problem with Long-Term Steroid Use
Steroids are meant for short-term flare control — not as a long-term strategy.
While they can provide quick relief, repeated or prolonged use often leads to:
- Weight gain and fluid retention
- Sleep disturbances and mood changes
- Increased risk of infections
- Osteoporosis and bone loss
- Adrenal suppression
- Ongoing inflammation once the steroids are stopped
Many patients feel stuck — they taper down, symptoms return, and they end up right back on steroids again.
What the BSG 2025 Guidelines Say
The latest British Society of Gastroenterology (BSG) 2025 guidelines are clear:
If a patient is steroid-dependent or requiring frequent steroid courses, treatment should be escalated to advanced therapies — such as biologics or small molecules.
This includes options like:
- Infliximab (anti-TNF)
- Adalimumab, Ustekinumab, or Vedolizumab
- Tofacitinib or Upadacitinib in selected patients
These therapies aim to suppress inflammation more safely and sustainably.
My Approach in Dubai
If you’re in Dubai and facing repeated flares, the first step is proper evaluation.
This may include:
- Blood markers of inflammation (CRP, ESR)
- Fecal calprotectin
- Endoscopy or imaging to assess active disease
- Reviewing response to current medications
Once we confirm steroid dependency or lack of control, we move toward a personalized treatment plan, often involving biologics or immunom
You Deserve a Long-Term Plan
Living with IBD doesn’t have to mean living on steroids.
Modern treatments have transformed the way we manage Crohn’s and colitis — and they are available here in the UAE.
Looking for IBD care in Dubai?
Visit www.guthealthdubai.com