Make a big difference to our small charity.
Any funds you raise will go directly to providing better services for people with Crohn’s and Colitis.
Be part of something amazing…we can’t wait to have you on our team!
*No minimum sponsorship
Make a big difference to our small charity.
Any funds you raise will go directly to providing better services for people with Crohn’s and Colitis.
Be part of something amazing…we can’t wait to have you on our team!
*No minimum sponsorship
Can people with Crohn’s or Colitis have the COVID-19 vaccine?
Yes, unless you are under 16, or have certain other health conditions – ask your healthcare professional for more details.
Having Crohn’s or Colitis, or taking any medicine to treat your condition, will not stop you from being able to have the COVID-19 vaccine.
All of the available vaccines are suitable for people on biologics, steroids and immunosuppressants.
You are still able to have vaccines that are not ‘live’ vaccines, no matter what medicine you take for your Crohn’s or Colitis. None of the COVID-19 vaccines are classed as live, including the vaccine made by Oxford.
Visit the NHS website for general information about the vaccine and how it will be delivered : https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/ .
For information specific to Crohn’s and Colitis please visit: https://www.crohnsandcolitis.org.uk/news/latest-coronavirus-vaccine-for-people-with-crohns-or-colitis.
The Government has announced a relaxation of its guidelines for those individuals that are shielding. These changes come into effect on the 6th July and include removing the need to social distance within a household, meeting individuals from other households outdoors and forming support bubbles. The shielding programme is expected to be paused at the end of July.
For further details please refer to the Crohn’s and Colitis UK website here: https://crohnsandcolitis.org.uk/news/advice-for-people-with-crohns-and-colitis-self-isolation-social-distancing#new-shielding (“What do the new shielding guidelines mean for me?”) and the Government website here: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19.
The guidance is different for those that are deemed ‘clinically vulnerable’ and ‘clinically extremely vulnerable’.
It is important that all individuals remain to be careful and diligent about social distancing and hand hygiene.
Guidance is continually evolving. If you are uncertain about how to interpret the guidelines it is important to seek advice from your GP and/or IBD nurse/doctor. Alternatively, feel free to contact Jewish Digest and we will try and assist you.
By Dr Steven Mann, Consultant Gastroenterologist, 7th June 2020
Implications of having Inflammatory Bowel Disease during the Covid-19 pandemic.
In the UK, there are over 0.5 million people with IBD, namely Crohn’s disease or ulcerative colitis. Many of these patients will be on immunosuppressant drugs to control the gut inflammation. Over the last 3 months, patients have expressed concerns about the impact that IBD or the medication may have on their vulnerability to Covid-19 or its complications, or the impact that Covid may have on their own IBD. These have also been challenging times for patients being able to access their local IBD service due to service reconfiguration, cessation of face to face clinics, redeployment of staff to Covid duties, sick leave or isolation for health care professionals, etc.
Medication in IBD and Covid
The established risk factors for a worse outcome in Covid infection include older age, male sex, diabetes, obesity, and underlying cardiac or respiratory diseases. IBD per se does not increase the risk of acquiring Covid-19. The drugs used to treat IBD such as azathioprine, mercaptopurine, methotrexate or any of the biologics do not seem to confer any greater risk to the patient and the BSG and ECCO both advise patients to continue their medication. On the contrary, active disease does confer an increased risk of infection both in the community and in hospital, so stopping any medication should be discouraged to avoid the risk of a flare-up.
Do patients need to be shielded?
It appears that many patients have had letters or text messages form NHS sources advising them to shield for 12 weeks. The BSG has categorised patients into mild, moderate and high risk and these guidelines were published early in the outbreak and still hold true today. Most patients fall into moderate or lowest risk groups.
Low Risk- ‘social distancing’ as advised for the population in general.
Patients on the following medications:
► 5-ASA
► Rectal therapies
► Orally administered topically acting steroids (budesonide or beclometasone)
► Antidiarrhoeals (eg, loperamide)
Moderate Risk- ‘stringent social distancing’
– Anti-TNF (infliximab, adalimumab, golimumab, certolizumab) monotherapy
– Biologic plus immunomodulator in stable patients
– Ustekinumab
– Vedolizumab
– Thiopurines (azathioprine, mercaptopurine)
– Methotrexate
– Janus kinase (JAK) inhibitors (tofacitinib)
– Prednisolone less than 20mg/day
Highest Risk- ‘shielding’
– Intravenous or oral steroids ≥20mg prednisolone or equivalent per day (only while on this dose)
– Commencement of biologic plus immunomodulator or systemic steroids within previous 6 weeks
– Moderate to severely active disease not controlled by ‘moderate risk’ treatments
Drug information for Covid
– avoid if possible; shield if on a dose of more than or equal to prednisolone 20mg/day
-consider rapid tapering
-do not stop suddenly
-consider use of Budesonide in both Crohn’s and colitis
-if infected with the SARS-CoV-2, try and reduce prednisolone dose to less than 20mg/day or switch to Budesonide if possible
-no evidence for increased risk of Covid-19 infection
-if infected with the SARS-CoV-2,withhold the drug temporarily during the acute illness until 7-14 days after the illness
-no evidence for increased risk of Covid-19 infection
– consider initiation as monotherapy (without addition of azathioprine)
-if infected with the SARS-CoV-2, delay the dose for 2 weeks after the acute illness
-no evidence for increased risk of Covid-19 infection
-if infected with the SARS-CoV-2, delay the dose for 2 weeks after the acute illness
-no evidence for increased risk of Covid-19 infection
-if infected with the SARS-CoV-2, delay the dose for 2 weeks after the acute illness
-no evidence for increased risk of Covid-19 infection
-if infected with the SARS-CoV-2, delay the dose for 2 weeks or until the acute illness has resolved
-no evidence for increased risk of Covid-19 infection
Could IBD Therapies be protective against Covid-19?
There is some discussion in the literature that the sickest patients who end up on Intensive Care and needing ventilation have a heightened immune reaction the virus, and it is that overreaction that leads to complications. It has been postulated that biologics may protect against this abnormal immune response by dampening down the ‘overreaction’. This is under investigation and data being collected on an International Registry may answer this in due course (SECURE-IBD).
If patients wish to avoid attending the hospital or GPs are not doing blood tests, is that a concern on immunomodulators?
Under normal circumstances, patients on azathioprine, mercaptopurine and methotrexate will have blood test monitoring every 3 months or 2 months (methotrexate). In order to reduce the footfall in hospital or GP surgeries and in the interest of patient safety, there is a new extended monitoring recommendation for use during the Covid-19 pandemic. This allows for 6-monthly blood checks for patients on those drugs when they have been on a stable dose for some years or more than 6 months (methotrexate).
When can I have the colonoscopy that was advised before lockdown?
Following the cessation of all non-essential or non-emergency endoscopy in March 2020, hospitals are now working through processes to restart the service. There is a huge backlog of cases including many IBD patients.
Each Trust is responsible for implementing an infection control pathway that minimises any risk to the patient of catching coronavirus, but also of bringing it into the endoscopy unit. Guidelines have been published to facilitate this pathway. The capability and capacity to restore endoscopy practice will vary across different hospitals.
Patients will be screened with questionnaires and many units will swab patients 3-4 days prior to the procedure. Some units will be requesting that patients self isolate for 7 or 14 days pre-procedure.
IBD patients with a suspected new diagnosis will generally be permitted to have their endoscopy during this recovery phase in addition to patients who are being considered for escalation of therapy such as requiring biologics.
Routine surveillance of colitis patients will be deferred to beyond this recovery phase.
Top 10 tips for everyone with inflammatory bowel disease during the COVID-19 pandemic (BSG)
Since the infection is dynamic and knowledge and evidence are growing rapidly, some of this guidance will be updated as necessary.
Other links:
Crohn’s and Colitis UK have summarised the implications of the new UK government shielding guidelines that came into effect on 1st June 2020. The summary can be found here: https://www.crohnsandcolitis.
An international database called ‘Surveillance Epidemiology of Coronavirus Under Research Exclusion (SECURE-IBD)’ (https://covidibd.org/) has been collecting data to assess the impact of COVID-19 infection in patients with IBD. An article has been published in the leading journal Gastroenterology including data from 525 patients with IBD infected with COVD-19. A summary of the article can be found here: https://journalsblog.gastro.org/corticosteroids-but-not-tnf-antagonists-associate-with-adverse-covid-19-outcomes-in-patients-with-inflammatory-bowel-diseases/. Using the database, researchers found that in IBD patients increasing age, comorbidities (having other medical conditions) and corticosteroids but not anti-TNF medications were associated with severe COVID-19 infection. Further research is required to understand how these factors contribute.
Watch a recording of the Catherine McEwan Foundation IBD COVID-19 Q&A with Consultant Gastroenterologist Prof. Charles Lees and IBD Specialist Nurse Janice Fennell from 27th May 2020 here: https://www.facebook.com/watch/?v=563445997698539
The Prime Minister has issued specific COVID-19 guidance for the 1.5million most vulnerable people living with chronic illness in the UK. This advises ‘shielding’ measures to reduce the transmission of COVID-19 infection and the risks from COVID-19 disease.
The British Society of Gastroenterology have placed people with Crohn’s and Colitis into three groups:
You are strongly advised to carry on taking your medication, as stopping your medication will put you at higher risk.
For more details on social distancing and frequently asked questions please visit:
https://www.crohnsandcolitis.org.uk/news/advice-for-people-with-crohns-and-colitis-self-isolation-social-distancing
Guidance on social distancing for everyone in the UK and protecting older people and vulnerable adults
Important updated information on coronavirus as of 16th March 2020
What are the best foods to eat during a flare up of Crohn’s or Colitis?
Are fermented foods helpful for the gut?
Nutrition By Sylvie for answers these questions for Jewish Digest!
Thanks to Shimon Video Productions for filming this video.
Expert Q&A with Mr Daren Francis, Consultant Laparoscopic, Colorectal and General Surgeon for #CrohnsAndColitisAwarenessWeek #IBD #SurgeryforIBD
What are the most common surgeries performed for Crohn’s and colitis? 00:06
Is surgery a cure? 01:36
Is there a difference in surgery for children and for adults? 01:54
Can surgery affect fertility? 02:16
With a reversible stoma, how often do they actually reverse? 02:51
What is the likelihood of relapse post surgery? 03:48
Has the rate of surgery reduced since newer medications have been more successful in treating IBD over the past few years? 04:20
How has surgery changed over the years? 04:51
Are surgeons keen to always do surgery or do they try and avoid it if they can? 05:20
Having performed many surgeries, is the overall feedback from patients positive or negative? 06:40
Thank you to Shimon Video Productions for filming and editing this video.