Budesonide is a synthetic
steroid of the
glucocorticoid family with a high topical anti-inflammatory activity. Enteric-coated formulations resist gastric-acid degradation, delivering active
drug to the small intestine and proximal colon.
Budesonide has a high first-pass metabolism with minimal systemic absorption. It is therefore felt to cause fewer side effects than traditional glucocorticosteroids and to be generally well tolerated. The aim of this paper is to examine the utility of this medication in frequently encountered gastrointestinal conditions:
Crohn's disease,
ulcerative colitis,
microscopic colitis and eosinophilic oesophagitis. A Medline search was performed to find published original research and review articles relating to the use
budesonide in common gastroenterological conditions. The results showed that
budesonide is efficacious in the induction and short-term maintenance of
Crohn's disease.
Budesonide is the best-documented treatment for
microscopic colitis. It is well proven to be effective in the
induction of remission in
collagenous colitis but its use in
lymphocytic colitis remains less well documented. In conclusion,
budesonide is an effective glucocorticosteroid
therapy for many chronic
gastrointestinal diseases. In combination with its efficacy, the low incidence of serious side effects associated with this
drug should keep it at the forefront in the therapeutic arsenal of any gastroenterologist.