Three broad groups can be identified, although 50% of patients report no adverse event. Early effects are mainly due to high doses and include cosmetic effects (acne, moon face, oedema), sleep and mood disturbance, dyspepsia, or glucose intolerance. Effects associated with prolonged use (usually 12 weeks) include posterior subcapsular cataracts, osteoporosis, osteonecrosis of the femoral head, myopathy, and susceptibility to infections. Effects during withdrawal include acute adrenal insufficiency (from sudden cessation), a syndrome of myalgia, malaise, and arthralgia (similar to recrudescence of UC), or raised intracranial pressure. Complete steroid withdrawal is facilitated by early introduction of azathioprine, adjuvant nutritional therapy, or timely surgery.
One of the most frequent mistakes in the therapy of UC is the prolonged use of steroids (effective only in inducing clinical remission but not in maintenance). There is no excuse either for using them repeatedly for either frequent relapses, either for fruitless attempts at tapering them or for continuing them at homeopathic doses to maintain remission. Steroids are neither safe nor effective in any of these situations. Corticosteroids are often used for an excessive duration even in patients with mild disease without a clear "exit" strategy, utilising alternative drugs to maintain remission. The standard of practice worldwide is currently to maintain long-term remissions with either a high-dose of 5-ASAs, anti-metabolites, anti-TNF drugs, or even surgery, rather than with long-term or frequently repeated steroids .
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Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.