Steroid Precautions

In rheumatological practice, steroids are among the most common drugs prescribed by doctors, and their use might be recommended for a long period. But if you are a parent, it is natural to feel anxiety regarding the long-term effect of such medicines on your child's body. In such circumstances, it is important to understand the benefit the drug will have on the disease process, while also being aware of its side effects and learning how to minimise and deal with them.

Corticosteroids can cause a range of side effects, but they can also relieve the inflammation, pain and discomfort of many different diseases and conditions. If you work with your doctor in making medicinal choices, you can achieve significant health benefits for your child with a reduced risk of side effects.

Why steroids?

Steroids are potent anti-inflammatory and immune suppressant drugs. They are used in the pediatric age group, right from infancy to adolescence, for many conditions such as asthma, severe allergic reactions, arthritis and vasculitis, to name a few. Corticosteroids also suppress the immune system, which can help control conditions in which the immune system mistakenly attacks its own tissues i.e. auto-immune conditions.

What are the side effects and the precautions to be taken?

1) Gastritis: Steroids are known to cause gastritis, like many other medicines. To avoid this, it is important they be taken after food. Prophylactic anti-gastritis medicine are not required unless the child is symptomatic, or on a very high dose. In case of symptoms, discuss with your doctor. A small dose of anti-gastritis syrup / tablet may be recommended to help relieve the symptoms.

2) Weight gain: Steroids are notorious for causing water retention, causing puffiness of the face and resulting in an increase in appetite that can lead to weight gain. As a parent, this can sometimes seem falsely reassuring (happy to see your child gaining weight). Some measures that can be taken to prevent excess weight gain are:

  • Increasing roughage / fibre in your child's diet - sprouts, salad and low glycemic index fruits
  • Decreasing the total intake of carbohydrates and fat
  • Minimizing intake of sweet, rice, ghee, and oily, fried foods
  • Ensuring a healthy diet and encouraging participation in activities that help your child maintain a healthy weight and strengthen bones and muscles

3) Infections: Steroids suppress the immune system, which can lead to infections. Measures that can be taken to avoid this are:

  • Avoiding unhygienic food preparation
  • Properly washing all raw food
  • Taking contact precautions if any other family member is suffering from a contagious illness

4) Bones: It is important to take calcium and vitamin D preparations regularly as advised by the doctor. Calcium-rich food items may also be added to the diet to avoid bone-related side effects.

5) Eyes: Periodic eye check-ups should be undertaken as advised.

6) Blood pressure: Routine check-ups for blood pressure should be undertaken with your doctor in each visit, and as advised subsequently.

7) Vaccine: Vaccines should be avoided when the child is on high doses of steroids. Consult your rheumatologist before taking any vaccines.

At PREP Clinic, your doctor is ever-mindful of the negative effects steroids can have on your child's health, and is well-trained and experienced in the prudent use of such medicines. With regular consultations, open discussions and careful monitoring, we can attune the steroid treatment specifically for your child. Such measures, along with the advisory precautions listed above, can mitigate any side effects while greatly improving your child's health.