Videos

Medication to Treat Your Child's IBD Without Steroid Use

4.26.13

In this videos series, we address questions commonly asked by parents of children with IBD. For more information, check out our other videos on IBD at: http://www.youtube.com/playlist?list=PLjvfRtcMhn4OrxA2dD4k8qc5ajjhfpobr or visit: http://www.seattlechildrens.org/IBD. 0:08 So what are some of the strategies that we have to prevent the repeat use of steroids? We know that steroids come with a lot of side effects as you saw in our other video. And we know that preventing the use of steroids over and over is a good idea. Now we have three strategies that we use to treat our patients and prevent the repeat need for steroids. 0:28 One is for ulcerative colitis using mesalamines. Mesalamines are medications like Aspirin that coat the lining of the intestine and therefore reduce the inflammation. By reducing the inflammation and healing the lining of the colon, we prevent the need for more use of steroids. 0:46 The second strategy is to use immune modulators. Immune modulators are medications that try to balance the over-active immune system that produces the inflammation. These immune modulators come in pill form or injection form. For example, for ulcerative colitis, azathioprine or mercaptopurine can be used. For Crohn's Disease, azathioprine, mercaptopurine, and methotrexate can be used. 1:15 There's a category of biologic agents. Biologic agents are antibodies designed to neutralize some of the key components of the inflammation in IBD. These medications allow for the majority of patients, allow for the inflammation to be quiet, and they allow for the lining of the intestine to heal, which is a key target of our management plan. They also do not come with the side effects of steroids. 1:43 Now, they do have side effects of their own. Some of these side effects are allergies. They tend to be mild but sometimes they can be severe. That's very uncommon. They also could suppress the over-active immune system a little too much, which allows the body to get more infections than the average individual. That's why we screen for infections like tuberculosis when we are considering treatment with these options early on. 2:10 Now, there are rare instances where these medications were linked to developing malignancies or cancers. And fortunately, this is very, very rare. The key thing that we always have to think about is, are we using the medicine for the right reason? And if we are, is the risk of these rare adverse events of these medications worthwhile for the sake of controlling the inflammation, allowing the symptoms to be quiet in the long run, not just the short term, and also preventing the repeat use of steroids.