If you are taking steroids for ulcerative colitis, or you have just been prescribed your first course, one of the biggest questions on your mind might be this:
Are steroids worth it for UC?
For me, the honest answer is yes — up to a point.
- They worked.
- They worked quickly.
- They reduced my symptoms.
- They gave me relief when I badly needed it.
But they also came with side effects, and over time they stopped being a long-term answer. That is the part I think really matters.
Because when people talk about steroids for ulcerative colitis, it is easy to focus only on what they fix. But if you have lived through a course of steroids you know the bigger picture is not just about symptom control. It is also about what the steroids bring with them while they are helping.
This post is based on my own lived experience of taking steroids for UC over many years. It is not medical advice, but if you are trying to understand what a course of steroids can actually feel like day to day, this may help.
Steroids Helped My UC Symptoms
When I started taking steroids for ulcerative colitis, I could feel the difference very quickly. Within a day, things would begin to change.
My number of trips to the bathroom would drop. I would start to get some control back. My appetite would return. The discomfort would lessen. And eventually, if I stayed on them long enough, the bleeding would stop too. On paper, that sounds ideal.
And in one sense, it was. When you are in a proper UC flare, any relief can feel huge. Steroids were often the thing that got me through the worst periods. They could calm things down fast enough for me to function again. But “working” does not always mean “solving the problem.”
That is where the conversation gets more complicated.
What a Course of Steroids Felt Like for Me
Rather than jump straight into the side effects, I think it is more helpful to explain what a course of steroids actually felt like from the beginning.
For me, I would usually take them in the morning, just before or with breakfast. Within around an hour, I could start to feel the calming effect on my body. The urgency would ease. The number of toilet trips would lessen for a while. Pain and discomfort would begin to settle.
That was always one of the most striking things about steroids for me: how fast they could reduce inflammation.
With ulcerative colitis, the colon is inflamed. So as soon as that inflammation starts to come down, you often feel the difference quite quickly. That first morning dose could buy me a decent window in the day where I felt calmer, more comfortable, and far more able to cope. The problem was that, for me, the effect did not feel evenly spread across the whole day at first.
As the day went on, the steroids would begin to wear off. By evening and nighttime, the inflammation would start pushing back in. The bathroom trips would begin increasing again. Nights were often rougher. I would sometimes find myself looking forward to the next morning just so I could take the next dose and get that calming effect back in my system. That is how powerful they felt. They genuinely did work.
Then, after a few days on them, things would improve more steadily. The inflammation would not rebound as hard in the evenings. After about a week, nighttime could become more manageable. The overall flare would soften. From there, the course would usually taper down.
For me, a steroid course was often around 6 to 8 weeks, starting on a higher dose and then gradually reducing week by week, often by around 5mg at a time.
So in terms of treating the symptoms of UC, my answer is a big yes.
The Problem With Steroids: They Help, But They Come at a Cost
The same steroids that calmed my ulcerative colitis also brought side effects into my life.
I know there is a long list of possible side effects in the information leaflet. But I am not going to repeat a textbook list here. Instead, I want to share the side effects I actually experienced myself.
These were the real ones for me.
1. Moon Face
One of the most visible side effects I experienced was moon face.
My face would become fuller, rounder, and noticeably different in appearance. It was one of those changes that could affect how I felt about myself, because it was obvious and outward.
The good thing was that once I came off steroids, that effect would gradually fade. A few weeks later, my face would usually start returning more towards normal.
But while I was on them, it was definitely there.
2. Blotchy Skin and Mild Acne
Steroids also affected my skin.
I had blotchy skin and mild acne while taking them. Again, it was a visible side effect, and one more thing that came along with the treatment.
Once I stopped the steroids, the blotchiness and rash-like look would settle down.
That said, if I am being honest, after years of being on and off steroids, I do not think my skin has ever quite gone back to being as clear as it was before I first started taking them. Even now, I still feel like that period left its mark.
3. Sleeplessness and a Restless Mind
This was a big one for me. While taking steroids, I often found it hard to sleep.
My body would be tired, but my mind would be wide awake. At night my legs could feel twitchy. My thoughts would race ahead. It was like my system was always switched on and never properly settling down.
That nighttime restlessness was one of the hardest parts of being on steroids. You can be exhausted from the flare itself, but then still struggle to sleep because your body and brain feel over-revved.
Once I stopped the steroids, that intense restless feeling eased. But again, after years of repeated steroid use, I do wonder whether it left some longer-term impact.
Even now, I struggle to get to sleep without headphones in, just to help calm my mind down and take it out of gear.
So while the worst of the steroid restlessness did go, I do feel like my relationship with sleep was changed by that whole period.
4. Aching Muscles, Especially in My Legs
Another side effect I used to notice very quickly was aching muscles in my legs.
This would often begin within the first 24 hours of starting a course.
It felt like a deep ache in the muscles, almost as if the tissue itself was sore or chilled. It was particularly noticeable in my legs, and when it was bad I would sometimes use a hot water bottle just to take the edge off it and help the muscles relax.
The positive side of this one was that it usually only lasted the first couple of days. By day three, it would normally settle down. Once I stopped the steroids, the ache would disappear completely.
But it became so predictable that it was almost like clockwork. Start steroids, and my legs would start aching.
5. Irritability and Mood Swings
This is one of the side effects I think people can underestimate until they go through it.
Steroids affected my mood.
I became more irritable. Small things would get under my skin. I found it harder to let things go. I struggled to find peace in myself.
If I was at work all day, trying to stay calm and hold everything together, it could feel like being a fizzy bottle that had been shaken all day long. Then when I got home, sometimes it was like taking the lid off — the frustration would spill over.
What made it worse was that I often knew what was happening.
I knew the things upsetting me were small. I knew I was reacting more strongly than I normally would. But that did not automatically give me control over it. It still felt hard to stop.
Once the steroid course ended and everything cleared from my system, I would calm down again. I felt more like myself. But while I was on them, irritability and agitation were very real parts of the experience.
6. Increased Appetite and Weight Gain
Steroids absolutely increased my appetite.
It felt like someone had flicked a switch in my brain and left it permanently set to hungry.
I could eat a full meal and still want more. Snacks did not feel like enough. I could just keep eating. So yes — increased appetite and weight gain were definitely part of my experience too.
Like some of the other side effects, this usually settled once I came off the steroids. My appetite would return to normal, and my body would stop pushing those constant hunger signals.
But while I was on them, the hunger felt relentless.
The Hard Truth: Steroids Eventually Stopped Working for Me
This is the part I think is really important to say clearly. In my case, steroids were not the end of the journey. Eventually, they stopped being enough.
I could go on a high dose, calm things down, complete the course, and feel like I had pulled out of the flare. But then within days — or sometimes within a week of stopping — the ulcerative colitis would still be there underneath the surface, waiting to flare again.
Steroids would pull me out temporarily, but they were no longer creating lasting stability. They were buying time, not fixing the bigger problem.
That distinction matters.
Because I do think steroids can be incredibly useful, but I do not think they should always be seen as the long-term answer.
So, Are Steroids Worth It in a UC Flare?
If you are in a really bad flare and have been prescribed steroids, my answer would be this:
They can absolutely be worth it.
If you are very unwell, steroids can reduce inflammation quickly and give you relief when you need it most. They can help get symptoms under control, help you function, and they can help buy time.
But you also need to understand what else may come with them.
For me, the decision often came down to weighing up two things:
- a bad ulcerative colitis flare
- the side effects of steroids
For a long time, the scales tipped in favour of taking the steroids because uncontrolled UC can be brutal.
But I also think it is important to say this honestly: there comes a point where living on repeated steroid courses is its own kind of problem too.
Steroids Are a Tool, Not Always a Long-Term Solution
This is how I would describe steroids now:
They are a tool.
A powerful one.
They can calm inflammation, they can buy time and they can act as a bridge while doctors move you towards something else.
That “something else” may be a maintenance treatment, an immunosuppressant, or a biologic.
For example, when my daughter had her first severe flare with total colitis, steroids were used as the first-line treatment before she was then moved onto infliximab. That next-stage treatment made a big difference for her.
So steroids absolutely have a place. But I would be cautious about seeing them as the whole plan.
My gastroenterologist once told me that if a patient needs more than two or three courses of steroids in a year, they would see that as unstable ulcerative colitis.
That stuck with me. Because when I look back, I was on steroids far more than that.
My Honest View on Prednisolone for Ulcerative Colitis
If someone asked me today, “Are steroids worth it for ulcerative colitis?” I would say this:
Yes — they can be very worth it in the short term.
No — they are not always something to rely on long term.
- They helped me a lot and gave me relief.
- They reduced bleeding and eased my pain.
- They brought the inflammation down and they made life more manageable during bad flares.
But they also changed how I felt physically, mentally, and emotionally while I was taking them, and in the end, they stopped being enough on their own.
That is why I think the most balanced answer is not “steroids are good” or “steroids are bad.”
It is this:
Steroids can be incredibly helpful, but they come with trade-offs.
And if you are taking them, it helps to go in with your eyes open.
If You Are About to Start Steroids for UC
If you have just been prescribed steroids and are feeling anxious, that is understandable.
The best thing I can say from lived experience is this:
- they may help more quickly than you expect
- the side effects may be real, but some are temporary
- they can be an important step in getting a flare under control
- but if you keep needing them again and again, it may be worth asking bigger questions about your longer-term treatment plan
Write your questions down. Take them to your doctor or IBD team. Questions you might want to this about could be about side effects, what happens if symptoms return after the taper and what the next step is if steroids work only temporarily.
Because steroids may be part of the answer — but they are not always the whole answer.
Want to dive deeper into what living with ulcerative colitis and J-Pouch really feels like?
My book Ulcerative Colitis: Generations Apart shares the journey across two generations — raw, honest, and full of hope.
Find out more HERE
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