COVID-19 Recommendations: Researchers Issue Guidance For Managing Digestive Disorders

A couple of new research papers provided guidance for managing patients with digestive disorders such as inflammatory bowel disease during the coronavirus pandemic.

The researchers from the First Affiliated Hospital of Sun Yat-Sen University in Guangzhou, China, patients at risk for COVID-19 infection include those who are indulging in immunosuppressive agents, IBD patients and malnutrition, the elderly patients, those with underlying health conditions and the pregnant women.

Here’s what the recommendations for people suffering from gastric disorders during the outbreak are:

1. If your condition is stable, you can continue with your current treatment protocol.
2. Refrain from taking a new immunosuppressant or higher the dosage of immunosuppressant you already have been taking.
3. Take biologics including the anti-TNFs infliximab or adalimumab and if they are not accessible, take enteral nutrition.
4. Vedolizumab is specific to the intestine and so you can continue to take them.
5. Elective surgeries and endoscopies can be postponed.
6. In case of emergency surgery, get screened for COVID-19.

"Immunosuppressants such as azathioprine, mercaptopurine, and tofacitinib may affect the viral response, though this has not been proven in reference to COVID. If patients are doing well on their medications, they should stay on them. Enteral nutrition is usually quite difficult for most adult IBD patients and should not be attempted without physician guidance,” Medscape Medical News quoted gastroenterologist Dr. Shannon Lang of NYU Langone's Inflammatory Bowel Disease Center in New York City.

Per the second paper published in Clinical Gastroenterology and Hepatology, the researchers at the Mount Sinai Hospital’s Feinstein IBD Center in New York City, clinicians should be having a template message with general guidance for patients. A lot of misinformation is out there and clinicians can clarify by providing handouts with some of the main points from the CDC website.

“If patients have a text or email messaging system, this would also be a good method to distribute the information," he said. "For any office visits or procedures, clinicians should be pre-screening patients over the phone before they come to the office and if they have any concerning symptoms, they should be advised to stay home or go to ER if more severe symptoms (shortness of breath, etc.) arise," Dr. Ryan Ungaro told Reuters Health by email.