Telehealth has become part of our new normal as we practice physical distancing during the COVID-19 pandemic. Several of the barriers that prevented us from being able to see our doctors for an appointment via a telephone call or a video call have now been managed. However, it’s still a new way to receive healthcare, and both patients and clinicians are adjusting. Learn from Neilanjan Nandi, MD, gastroenterologist and Associate Professor of Clinical Medicine at Penn Presbyterian Medical Center and the University of Pennsylvania about what patients can do to be ready for their telehealth appointments and what it’s like from the doctor’s side of the video conference call.Continue reading
In this moment of physical distancing in order to flatten the curve of people being exposed to the novel coronavirus (SARS-CoV-2) and developing the disease it causes, COVID-19, it may prove challenging to receive medication to treat inflammatory bowel disease (IBD). Certain medications that are given to manage Crohn’s disease and ulcerative colitis are given by infusion. This is most often done at a doctor’s office, infusion center, or at a hospital.
People with IBD have questions about the safety of receiving infusions outside the home at this time. In addition, there have been reports of infusions centers closing for the indefinite future, leaving patients to find another location to receive their medication. All the major gastrointestinal organizations and IBD specialists are recommending that patients still receive their medication at this time. It’s currently thought that the focus should be on avoiding an interruption in care and running the risk of an IBD flare-up. This article will provide resources in order to help patients navigate the closing of an infusion center.Continue reading
People with inflammatory bowel disease (IBD, Crohn’s disease, ulcerative colitis, or indeterminate colitis) are understandably concerned about the novel coronavirus, and the disease it causes, COVID-19, spreading in their community. People who have certain medical conditions and/or are receiving immunosuppressive medications may be at a greater risk of complications for COVID-19. There are some guidelines put out specifically for people with IBD that can help in making decisions during this time. On this page you will find trusted and verifiable resources that help you as you make choices regarding travel, medications, and everyday life during the pandemic.
May 3, 2020 Update
There are now 877 reported cases of COVID-19 in people with IBD. There have been 30 deaths entered into the database: 23 of these were in people over the age of 60. See the update from the SECURE-IBD Registry.*
The International Organization For the Study of Inflammatory Bowel Disease met on Friday, March 20th. They continue to meet every week. Some of the recommendations from this group were reported by David Rubin, MD of the University of Chicago via Twitter (see original Tweets or view the thread here) and included:
- Having IBD is not a risk factor for infection with the novel coronavirus (SARS-CoV2) or for developing the disease COVID-19
- Active inflammation MAY increase the risk of infection
- Patients should stay on their therapies in order to stay in remission
- Diarrhea is a common symptom in patients with COVID-19 and in the small number of people with IBD who have developed COVID-19
- Infusion centers with an appropriate screening protocol are OK
- Elective switching from IV to injection therapy is not recommended at this time
- The safety of home infusions is uncertain. (An infected home infusion nurse could be less safe than an experienced and secure infusion center.)
- It’s recommended to delay/postpone all non-essential endoscopic procedures
- Prednisone is not recommended, as this drug may increase risk of infection
- Tapering prednisone safely is generally advised, but especially if a patient has been exposed to the novel coronavirus (SARS-CoV2) or tests positive
General Guidelines for People With IBD
- Keep taking your medications. Many recommendations advise that people with IBD not stop their medications. Most IBD medications do not leave the body in the short-term and stopping medication could lead to a risk of an IBD flare-up. Talk to your physicians about your specific needs.†
- Risk of infection may not be increased. Receiving immunosuppressant medications does not increase the risk of contracting SARS-CoV2.‡
- Practice social distancing. Stay home as much as possible, especially avoiding large crowds in places with no ventilation, practice good hygiene and cleaning methods (see below), and follow other recommendations from your local public health officials.
- Use telehealth services. Ask your IBD physicians about conducting follow-up visits using telemedicine (such as over the phone or a video chat).
- Reschedule elective procedures. Consider postponing elective colonoscopy or other procedures.§
- Call ahead if you are sick. If you get sick with COVID-19—like symptoms (see articles below for more information) call your physicians to get instructions. If you experience difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or the inability to arouse, or bluish lips or face, seek medical help immediately.||
- Contact the Crohn’s and Colitis Foundation’s IBD Help Center for questions, or see links to international Crohn’s and colitis patient advocacy groups below.
*Brenner EJ, Ungaro RC, Colombel JF, Kappelman MD. SECURE-IBD Database Public Data Update. covidibd.org. Accessed on 05/03/20.
†Crohn’s and Colitis Foundation. IBD patient guidance. CrohnsColitisFoundation.org. 12 March 2020.
‡Crohn’s and Colitis UK. Coronavirus (COVID-19) advice. CrohnsandColitis.org.uk. 13 March 2020.
§Mao R, Liang J, Shen J, et al. Implications of COVID-19 for patients with pre-existing digestive diseases. Lancet Gastroenterol Hepatol. Published online March 11, 2020. doi:10.1016/S2468-1253(20)30076-5
||Centers for Disease Control and Prevention. People at risk for serious illness from COVID-19. National Center for Immunization and Respiratory Diseases (NCIRD). 10 March 2020.