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Self-medication with steroids in inflammatory bowel disease

Digestive and Liver Disease, In Press, Accepted Manuscript, Available online 17 October 2015, Available online 17 October 2015

Abstract

Background

The self-prescribing rates of corticosteroids in inflammatory bowel disease (IBD) patients treated with biologicals are unknown.

Aim

To investigate the frequency and modalities of self-medication with steroids in adult IBD patients.

Methods

Patients with IBD who attended Nancy University Hospital between November 2012 and May 2013 were included in the study. Patients were interviewed using an 11 item questionnaire.

Results

100 patients participated in the survey. In total 15 patients (15%) had already used corticosteroids without medical prescription since their IBD diagnosis and 4 patients of them (27%) used steroids as self-medication while on anti-TNF treatment. The mean total duration of corticosteroid treatment was 24 days (range, 1.5-105). In total 4 patients (27%) used corticosteroids more than 10 times without medical prescription (range 1-20). The two main reasons were: the need for quick relief of symptoms (n = 6) and the unwillingness to consult a physician (n = 3).

Conclusion

A relatively high proportion of patients with IBD use corticosteroids without medical prescription. Due to their side effects, self-medication may include ‘steroid dependency’ as it may reflect uncontrolled disease. As steroids have significant side effects and patients may have active disease it is important to counsel patients and to monitor their self-prescribing patterns in IBD patients.

Keywords: self-medication, inflammatory bowel disease, steroids.

Footnotes

a Inserm, U954 and Department of Hepato-Gastroenterology, Nancy University Hospital, Université de Lorraine, France

b Department of Gastroenterology. Ulster Hospital, Belfast N Ireland. UK

Corresponding author. Inserm U954, and department of Hepato-Gastroenterology, Nancy University Hospital, Université de Lorraine, Allée du Morvan, 54511 Vandoeuvre-lès-Nancy, France Tel.: +33 3 83 15 36 61 fax: +33 3 83 15 36 33