Purpose: To study whether irritable bowel syndrome (IBS) is associated with the use of oral steroids and whether there is a dose- or duration-response.
Methods: We followed up a cohort of 65,270 patients aged 20-74 years old enrolled in the General Practice Research Database in the UK with at least one prescription for steroids between 1994 and 1999. We performed a nested case-control analysis to estimate the adjusted relative risk (RR) associated with the use of steroids using unconditional logistic regression. Cases were 466 patients with a first episode of IBS during follow-up and controls were 5000 individuals randomly selected from the study cohort.
Results: Current users of oral steroids presented an RR of 0.6 (95% CI: 0.4-0.9) compared to non-users. Doses greater than 10 mg of prednisolone daily were associated with an RR of 0.4 (95% CI: 0.2-0.9). When we stratified by age, no reduced risk of IBS was apparent under the age of 40 years. The reduced risk of IBS was greater among females than males.
Conclusions: Our results suggest that oral steroids can reduce the risk of a diagnosis of IBS. The apparent effect modification of age and sex deserves further research.