When to transition IV steroids to oral steroids for Irritable Bowel Syndrome (IBS)?

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Last updated: March 23, 2025View editorial policy

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From the Research

The transition from intravenous (IV) to oral steroids for inflammatory bowel syndrome (IBS) is not typically recommended, as IBS is a functional gastrointestinal disorder that does not usually require steroid treatment, according to the most recent guidelines 1. When considering the management of IBS, it's essential to focus on symptom relief and quality of life. The Japanese Society of Gastroenterology (JSGE) published evidence-based clinical practice guidelines for IBS in 2021, which emphasize the importance of diet therapy, behavioral modification, and gut-targeted pharmacotherapy as first-line treatments 1. Some key points to consider when managing IBS include:

  • Diagnosis is based on the Rome IV criteria
  • Step 1 therapy consists of diet therapy, behavioral modification, and gut-targeted pharmacotherapy for 4 weeks
  • For non-responders, management proceeds to step 2 therapy, which includes a combination of different mechanistic gut-targeted agents and/or psychopharmacological agents and basic psychotherapy for 4 weeks
  • Step 3 therapy is for non-responders to step 2 and comprises a combination of gut-targeted pharmacotherapy, psychopharmacological treatments, and/or specific psychotherapy It's crucial to note that steroids are not typically recommended for IBS treatment, as they are usually reserved for inflammatory bowel diseases (IBD) such as Crohn's disease and ulcerative colitis, as discussed in other studies 2, 3, 4. In the context of IBD, the transition from IV to oral steroids is a common practice, but this is not directly applicable to IBS management. Instead, healthcare providers should focus on providing personalized care and symptom relief for IBS patients, using the most up-to-date guidelines and evidence-based treatments 5, 1.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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