Most of the tablets available for systemic corticosteroid therapy are made with insoluble steroid alcohols or acetates. This has two theoretical disadvantages, absorption may be uncertain and fragments of tablets may remain in contact with the gastric mucosa and lead to erosions. There is good evidence in children that absorption of the ordinary tablets of prednisolone is inconsistent1 but few studies have been made with other synthetic or modified steroids. The concept that part of a steroid tablet causes a gastric erosion is purely theoretical but dyspepsia is undoubtedly more troublesome with oral corticosteroid therapy than it is with parenteral therapy, corticotrophin injections or in naturally occurring Cushing's syndrome.
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