Does steroids really cause peptic ulcers?
Peptic ulcer is any mucosal erosion of an area of the gastrointestinal tract. It may be equal to or greater than 0.5 cm. It usually manifests as abdominal pain, nausea, vomiting, weight loss and loss of appetite. Peptic ulcers were believed to be also caused by certain drugs like steroids and aspirin.
According to multiple studies, steroids have a dual effect in the gastrointestinal tract. It can stimulate secretions but may also inhibit the production of mucosubstances. Steroids may also destroy the secretion of gastric alkaline in response to physically harmful stimuli but have absolutely no effect on the secretion of duodenal bicarbonate.
Prolonged administration of Prednisone in one study resulted to the formation of peptic ulcer by a reduction in adherent and soluble mucus in the GI tract. There were also studies linking steroids to an increase in the production of acidic substances. Continuous administration led to a condition called gastrinemia.
Looking at the previous random studies, researchers finally conclude that steroids may only cause peptic ulcers in two instances, if it was taken for more than a month and in cumulative doses equivalent to or exceeding 1000 mg of Prednisone. Later studies also proved that steroids used in combination with non-steroidal anti-inflammatory drugs (NSAIDS) caused peptic ulcer to develop.
According to the British Medical Journal:
Steroids cause peptic ulcers only when given together with non-steroidal anti-inflammatory drugs.
Many clinicians continue to believe that steroid drugs cause peptic ulcers, In reality the effects of these drugs on the gastroduodenal mucosa are far from clear cut; the evidence is fogged by conflicting data, many of them coming from many years ago.
