“…There has been general agreement that peptic ulcers in steroid patients show less surrounding edema, spasm, and scarring, perhaps related to the anti-inflammatory effect of the corticosteroids [25,36,37]. Some reports have emphasized the relatively silent nature of peptic ulcer disease in patients on corticosteroids and an associated high complication rate from bleeding and perforation, but no obstruction (decreased inflammatory response) [25,34,36]. The possibility of colonic perforation related to corticosteroid use has also been raised, both in a diseased colon involved with diverticulitis or ulcerative colitis and in an otherwise normal colon presenting with punched out ulcerations [29,38,39].…”