Oral Steroids actually is referring to steroids that are given systemically. This can be in the form of oral steroids (usually prednisone or medrol) or steroid injections (in the buttocks) such as triamcinolone, or solumedrol. These treatments are primarily used as a “rescue” to treat a flare up. They work quite well and can help bring someone who is having a flare up quickly back to their baseline. They will work both for flare ups of the sinuses or for asthma.
Also they can help shrink nasal polyps and when used periodically over the course of a year, can help delay or prevent the need for surgery. Systemic steroids work quite well for AERD. The problem is that they have serious side effects when used in higher doses over long periods of time. They can decrease the body’s ability to fight infection, they can increase blood sugar levels, they can cause weight gain, they can cause mood instability, and can significantly affect the risk of osteoporosis (bone thinning). Most of these risks are associated with long term use (months) and not as much with the typical “bursts” that may be given once or twice a year.
Some patients are so miserable or have significant risk factors that they are on daily oral steroids. Doctors will hopefully try to find the lowest dose to keep things under control, but even at lower doses, the side effects mentioned can be an issue. The need for daily steroids is something that should prompt a discussion of all of the risks and benefits of being on this treatment.