COVID-19: advice for patients with digestive conditions such as IBD

COVID-19: advice for patients with digestive conditions such as IBD
iStock-Samara Heisz

A new paper has outlined key information for patients living with chronic digestive conditions, such as IBD, in relation to COVID-19, or coronavirus.

A paper published today in Clinical Gastroenterology and Hepatology by clinicians at Icahn School of Medicine at Mount Sinai outlines key information that gastroenterologists and patients with chronic digestive conditions, such as inflammatory bowel disease (IBD), need to know about COVID-19, or coronavirus.

Coronavirus is of particular concern for patients with inflammatory bowel disease (IBD) who may take immunosuppression drugs. The paper, published in a journal of the American Gastroenterological Association, has provided clear guidance.

Information for patients with IBD

The paper states: ‘Patients on immunosuppression drugs for IBD should continue taking their medications. The risk of disease flare far outweighs the chance of contracting coronavirus. These patients should also follow CDC guidelines for at-risk groups: avoid crowds and limit travel.’

Ryan Ungaro, MD, MS, assistant professor of medicine at Icahn School of Medicine at Mount Sinai, said: “This is a rapidly evolving area with new information emerging on a daily basis.

“While COVID-19 is a significant global public health concern, it is important to keep its risks in perspective and stay up-to-date on current research and recommendations in order to provide our patients with the most accurate advice.”

How do I know if my symptoms are real?

Jane Ogden, Professor in Health Psychology at the University of Surrey, said: “Much as the serious symptoms of COVID-19 are clearly undisputable, those experienced in the early days following exposure to the virus are all too familiar and open to all the biases of symptom perception that influenced our daily lives way before this recent pandemic hit us. This process of symptom perception isn’t always helped by the constant bombardment by the media which can lead to health anxiety and hypervigilance which in turn make any symptom worse.

“Every year I carry out a study with my students to illustrate how symptoms are perceptions not sensations.  They all take part in a leg raising task when they sit down with their backs against the chair and lift a leg up horizontally for one minute whilst either relaxing, describing how it feels, chatting about their weekend or doing nothing.    They then rate how much it hurts and every year it works a dream – pain is significantly greater when they focus on their leg than when they are distracted.

“Symptoms are clearly modified by mood (anxiety makes them worse) and cognition (being distracted make them better).  And in today’s world of coronavirus who can’t help but watch their body for changes, worry about their tickly throat and check their forehead for any hint of a fever.  All of which will also make these symptoms feel worse than they are. But symptoms are also contagious in more ways than just through the virus.

“In 1982 David Mechanic described a syndrome called medical student’s disease which illustrated how medical students often ‘caught’ the disease they were studying in class.  So, they experienced chest pain when studying cardiology or breathlessness when in respiratory classes.  A few years ago, I also carried out a study on the social contagion of symptoms and found that when watching films of head lice or people jumping into icy water, participants either itched or shivered.

“We live in strange times when we need to know whether we are ill or not to protect those who are more vulnerable. But this process is not without its problems and whilst telling people to be vigilant of their symptoms may well help identify real symptoms of COVID-19 it may also exacerbate a whole load of more minor symptoms which would have been better ignored. This may lead to unnecessary self-isolation and pressure on workplaces such as schools when people stay at home.”

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