Know How Our Icliniq Doctor Followed Up to Patient’s Doubts Over Steroid Side-Effects

A patient who had a few follow-up questions after a phone consultation with our iCliniq doctor approached him to get them clarified. She asked our doctor whether local steroids caused lesser side effects than systemic steroids and wanted to know about the difference in side effects between biologics and steroids. She mentioned she was worried about taking steroids, considering she was anti-cardiolipin positive and was on medication.

Our iCliniq doctor responded that local steroids had fewer side effects than systemic steroids and confirmed that biologicals caused more side effects than steroids. He further informed her that she could simultaneously take the medication she was on along with taking steroids.

The patient reverted and asked about the typical length of steroid treatment. She also inquired about muscle wasting as a side effect of Crohn's disease and mentioned she was diagnosed with UCTD (undifferentiated connective tissue disease) with SLE (systemic lupus erythematosus) like symptoms. The patient expressed concerns about the possibility of lupus enteritis instead of Crohn's disease and asked if it could be differentiated on her upcoming colonoscopy.

Our doctor said steroid treatment was needed for two to three months and could be tapered down once symptoms were controlled. Our doctor explained that weight loss and anemia might occur in Crohn's disease, but muscle wasting was never reported. Our doctor informed the patient that they could discuss her condition after the colonoscopy and decide on the next steps.

The patient reverted after her colonoscopy and mentioned that her colonoscopy reports were normal, but her calprotectin levels were elevated, and her CT (computed tomography) scan showed abnormal results. She asked about the reason for it and whether it was possible for IBD to be found in CT enterography but not in colonoscopy. The patient also mentioned that she had been on prescription medicines to rule out GI issues. However, though they made her feel better, she experienced sudden diarrhea and stomach cramping when not taken. She later told our doctor she had undergone a capsule endoscopy that showed inflammation in the same place as the CT enterography. She also mentioned her stool being semi-solid, taking steroids, and being diagnosed with the beginning stage of Crohn's disease. She asked our doctor if she needed to take other medications after the steroid she was on or stop it and take it again if the symptoms returned.

Our doctor replied to the patient and assured her that her symptoms were unrelated to IBD and that CT scans could be falsely positive, but a colonoscopy was confirmatory. Our doctor further informed her that it was unnecessary to taper off the steroid but to stop and see if the symptoms recurred. Our doctor said that if she had evidence of Crohn's, she should use other medications simultaneously with the steroid and continue with it even after stopping the steroids. The doctor further advised her not to be confused but to try his suggestion and observe.

The patient thanked our doctor for helping her and explaining everything in detail. She mentioned that our doctor was prompt in answering her questions and that he even left a voicemail after she had missed his call. She mentioned that the appointment was difficult due to the difference in time zones, but our iCliniq doctor went out of his way to ensure they could communicate effectively. The patient appreciated the extra effort made by our doctor and described it as a kind gesture.