As of this writing, for the past two months, I have not been to a pharmacy or a grocery store. I have used a delivery service. I, like many other people who live with inflammatory bowel disease (IBD), am immunocompromised because of the medication I receive. I am now reliant on other people to obtain the things we need for our household, but it’s unclear to me if this is the right decision.Continue reading
I attended a briefing given by the American Gastroenterological Association (AGA) which was focused on COVID-19 and how the disease may affect people who live with inflammatory bowel disease (IBD). The briefing was given by three specialists: AGA Patient Education Advisor, Rajeev Jain, MD, AGAF, of Texas Digestive Disease Consultants; David T. Rubin, MD, AGAF, Joseph B. Kirsner Professor of Medicine, Chief, Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Illinois; and Russell D. Cohen, MD, AGAF, Professor of Medicine, Director, Inflammatory Bowel Disease Center, University of Chicago Medicine, Illinois. Drs Jain, Rubin, and Cohen are all integral in the IBD community and generously lend their time and expertise to helping both healthcare professionals and patients better understand IBD. What follows are highlights from this presentation that illustrate what has been learned so far about the intersection of IBD and COVID-19.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.