Can you take statins if you have colitis? Understanding the Evidence

October 14, 2025 •

4 min read

Recent research from Stanford Medicine suggests that people with ulcerative colitis who take statins have a significantly decreased risk of colectomies and hospitalization. While promising, other studies present conflicting results, making the question 'Can you take statins if you have colitis?' a complex one that requires a careful, individualized approach.

Quick Summary

The decision to take statins with colitis involves weighing established cardiovascular benefits against mixed data on inflammatory bowel disease effects. Some studies show reduced complications for ulcerative colitis patients on statins, while others report conflicting outcomes.

Key Points

Potential for Ulcerative Colitis: Some studies show that statin use is associated with a reduced risk of complications like colectomies and hospitalizations for patients with ulcerative colitis.
Mixed Results in Clinical Trials: While observational studies are promising, some clinical trials have yielded conflicting results, with one even suggesting a potential for worsened outcomes in acute UC.
Distinction between IBD Types: The effects of statins may differ between ulcerative colitis and Crohn's disease, with more evidence supporting a benefit in UC.
Anti-Inflammatory Properties: Beyond cholesterol-lowering, statins have 'pleiotropic' effects, including potential anti-inflammatory properties that may influence inflammatory conditions like colitis.
Consult a Healthcare Provider: Due to conflicting evidence, the decision to take statins with colitis should be made in consultation with a doctor, who can weigh the cardiovascular benefits against the potential GI effects.
Not a Primary Treatment: Current clinical guidelines do not recommend statins as a primary treatment for IBD, emphasizing that more research is needed.

The Dual Role of Statins: Cholesterol-Lowering and Anti-Inflammatory Effects

Statins are a class of drugs widely prescribed to lower cholesterol levels and reduce the risk of cardiovascular disease (CVD). Their primary mechanism involves inhibiting the enzyme HMG-CoA reductase, which helps produce cholesterol in the liver. However, researchers have also discovered that statins possess 'pleiotropic' effects, which are actions beyond their primary purpose. A notable pleiotropic effect is their immunomodulatory and anti-inflammatory properties, which has led to research into their potential impact on chronic inflammatory conditions like inflammatory bowel disease (IBD).

Ulcerative colitis (UC) is a form of IBD characterized by chronic inflammation and ulceration of the large intestine lining. This persistent inflammation not only causes painful symptoms but also increases the risk of complications, including colorectal cancer. It is the anti-inflammatory potential of statins that has prompted scientific inquiry into their effects on UC and Crohn's disease (CD).

Mounting Evidence Suggests Potential Benefits for Ulcerative Colitis

Several studies, particularly large observational ones, have revealed encouraging associations between statin use and improved outcomes for UC patients. A landmark 2021 study by Stanford Medicine found that UC patients taking statins had a nearly 50% reduction in the risk of undergoing colectomy (colon removal surgery) or requiring hospitalization. This was attributed to the drugs' anti-inflammatory capacity.

More recently, an April 2025 nationwide cohort study using Swedish healthcare registers provided further support. This research examined almost 20,000 adults with UC and found that statin use was associated with a reduced risk of:

IBD-related surgery
Hospitalizations
Disease flares

In addition to managing flares and reducing the need for surgery, some evidence suggests statins may help reduce the long-term risk of colorectal cancer, a known risk factor for patients with IBD. A 2023 study published in The Lancet eClinicalMedicine highlighted a duration-dependent reduction in colorectal cancer risk and mortality in IBD patients using statins for at least two years.

Differing Effects on Crohn's Disease and Conflicting Results

It is important to note that the findings regarding statins and inflammatory bowel disease are not uniform across all types of IBD. Some studies have shown less significant or no beneficial effect for Crohn's disease (CD) patients compared to those with UC. For instance, the large Swedish cohort study showed a reduced risk of IBD-related surgery in CD patients on statins but no significant reduction in hospitalizations or flares, unlike in UC patients.

Furthermore, not all research supports a beneficial role for statins in colitis. A 2017 study found that some UC patients treated with atorvastatin (Lipitor) experienced worsened symptoms compared to those on a placebo. Reviews on the topic, such as one published in the European Journal of Internal Medicine, have concluded that while experimental data in animal models are promising, clinical studies have limitations and conflicting outcomes. Current evidence is insufficient to recommend statins specifically for IBD treatment or prevention.

Potential Risks and Mechanisms

Though generally considered safe for cardiovascular health, statins are not without potential risks for colitis patients. Rare case reports have suggested an association between statin use and exacerbation of UC symptoms or development of ischemic colitis. The mechanisms behind statins' effects on the gut are an active area of research. Some theories suggest statins interact with the gut microbiome, which can influence intestinal inflammation and barrier function. However, the exact nature of this interaction is still being investigated, and some studies show contradictory effects on gut inflammation.

Weighing Benefits and Risks: A Comparison Table


Aspect	Potential Benefits	Potential Risks	Nuances and Evidence
Inflammation	Modulates inflammation due to pleiotropic effects.	Potential to exacerbate symptoms in rare cases.	Conflicting clinical data; observational studies show benefit, while some RCTs show negative effects in acute UC.
Disease Severity	Reduced risk of hospitalization and flares in UC patients.	No clear effect on disease progression in all cases or in CD.	Strongest evidence for UC, with a 2025 study showing reduced surgery, hospitalizations, and flares.
Steroid Use	Associated with reduced oral steroid use, particularly in UC.	Not a replacement for standard colitis medications.	Longer duration and higher adherence to statin therapy show better outcomes in retrospective studies.
Colorectal Cancer	May lower long-term risk of CRC in IBD patients, especially UC.	Benefit is duration-dependent and requires more research.	Swedish study found duration-dependent benefit, especially for those with UC and longer disease duration.
Gut Microbiome	May increase anti-inflammatory bacteria.	Can alter gut bacteria, potentially inducing inflammation in some cases.	Research is ongoing and shows both positive and negative effects on the microbiome, depending on the specific statin and bacteria.

Conclusion: Navigating Statins and Colitis

The question of whether you can take statins if you have colitis is best answered in consultation with a healthcare provider. While statins are generally safe and provide significant cardiovascular benefits, their effect on colitis can be complex and depends on the type of IBD and individual patient factors.

For patients with pre-existing colitis, the decision is a balance between the proven cardiovascular protective effects and the less-certain impact on bowel inflammation. The promising data, especially regarding a less severe disease course and reduced cancer risk in UC, is tempered by conflicting results and anecdotal cases of flares. Ultimately, statins are not currently recommended as a primary treatment for colitis, and more high-quality prospective research is warranted to clarify their role.

Things to Discuss with Your Doctor

Existing Symptoms: Report any changes in your colitis symptoms after starting statin therapy.
Cardiovascular Needs: Discuss your cholesterol levels and overall cardiovascular risk to weigh the benefits of statin treatment.
Type of IBD: Note that research suggests varying effects for ulcerative colitis versus Crohn's disease.
Alternative Therapies: Ask about other lipid-lowering therapies if you experience adverse gastrointestinal effects.
Monitoring: Understand how your doctor will monitor your colitis and heart health while on statin therapy.
Treatment Goals: Clarify if statin use is for cholesterol management or if any potential IBD effects are being considered.

For additional information on the broader effects of statins and inflammation, the National Institutes of Health provides extensive resources on the topic.

Frequently Asked Questions

Yes, in most cases, statins are considered safe for individuals with colitis. However, the decision should be made with a doctor, as some conflicting research and rare case reports suggest a potential for flare-ups or adverse effects in a small number of patients.

Some retrospective studies have shown associations between statin use and reduced disease severity, less frequent flares, and lower rates of steroid use, particularly for ulcerative colitis. However, other clinical trial results are mixed, and statins are not currently a standard treatment for colitis.

Yes, research indicates that statins may have different effects on the two primary types of inflammatory bowel disease. Studies have shown clearer and more frequent positive associations with ulcerative colitis, while the evidence for Crohn's disease is less consistent.

Although rare, potential risks include a possibility of exacerbated colitis symptoms or induction of ischemic colitis. Some studies have also indicated potential negative impacts on the gut microbiome and intestinal barrier function in animal models.

You should not stop taking any prescribed medication without first speaking to your doctor. If you experience a flare-up while on statins, discuss your symptoms with your healthcare provider, who may consider switching to a different type of statin or another lipid-lowering medication.

No, current clinical guidelines do not recommend using statins specifically for the treatment or prevention of inflammatory bowel disease. More high-quality, prospective research is needed to determine their exact role in managing IBD.

Beyond their cholesterol-lowering effects, statins have immunomodulatory and anti-inflammatory properties that can influence gut inflammation. They can also interact with the gut microbiome, though the effects on the gut barrier and inflammation are complex and still being researched.