chapter  13
The Role of Steroids in the Management of Crohn's Disease
Pages 6

The advent of corticosteroids has favorably altered the management of many disease processes---50me of known and others of unknown cause. This has been particularly true for Crohn's disease, a clinicopathological process in which the cause remains unknown 45 years after steroids became available, but, with these agents, came a degree of control over the disease, serving to convert it to a stage of inactivity or, at the very least, relieve acute symptoms. Unfortunately, the overwhelming relief that steroids provided led to relative complacency and inaction because it was believed that, with modification of dose or intermittent use of steroids, the disease could be controlled. During those early years gastroenterologists depended on sulfasalazine and the steroids for treatment of Crohn 's disease until it was recognized that the steroids had no maintenance or prophylactic value either for ulcerative colitis or Crohn 's disease ( 1-4). This has been con fumed by controlled trials (5-8). Meanwhile, the way in which steroids were used had led to less surgery and the postponement of surgery but the development of complications, some irreversible, arising from either the disease or the drugs used in its treatment (8,9).