Corticosteroids are a nonspecific immune modulator used in the treatment of ulcerative colitis. Topical and systemic forms of corticosteroids have been shown to be effective in induction of clinical remission and remain first-line therapy for acute severe ulcerative colitis. A large proportion of patients experience adverse effects, however, including some serious adverse effects, including infection and increased mortality. Newer formulations of gut selective corticosteroids have reduced adverse effects associated with steroids.