Self-medication with steroids in inflammatory bowel disease

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. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.