People who haveinflammatory bowel disease (IBD), may have special concerns regarding the novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19. These risks relate to medications, prior surgery, or immunosuppression. However, IBD itself is not currently thought to be a risk factor for COVID-19.
The international IBD community, through theInternational Organization for the Study of IBD (IOIBD)and other non-profit organizations, is sharing knowledge and experience, and guidelines are emerging regarding COVID-19 precautions, treatments, and vaccination for people with IBD.
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Managing IBD During the Pandemic
People with IBD may be concerned about continuing their medications when there is a risk of developing COVID-19. This is because some IBD medications that dampen the immune system to prevent inflammation in and around the digestive system can make you more susceptible to infections.
COVID-19 and Pre-Existing Conditions: Understanding Your Risk
IBD experts agree it is critical for people with IBD to continue to receive their medications as scheduled. This increases the chances of staying in remission and helps prevent anIBD flare-up.
Untreated Crohn’s diseaseorulcerative colitiscould lead to serious health problems that can include nutritional deficits due to malabsorption, or intestinal complications that could require surgery.
Receiving Medication Infusions
The IOIBD agrees that going to an infusion center is the best choice, as long as there are measures put in place.
Some of the precautions taken at infusion centers include:
IBD and Immunosuppression
While you may be particularly worried about protecting andbolstering your immune systemduring COVID-19, know that Crohn’s disease, ulcerative colitis, andindeterminate colitisdo not inherently cause immunosuppression. Rather, it’s certain medications that can cause immunosuppression.
People receiving the following drugs arenotconsidered to be immunosuppressed:
The following medications used for treating IBD will suppress the immune system:
Because they stay in the body for a long period of time, stopping immunosuppressive medications will not have an immediate effect on the immune system.
People with IBD who have had surgery to treat their disease and who currently have an ostomy (ileostomyorcolostomy) or aj-pouch(ileal pouch anal-anastomosis, or IPAA) are also not considered to be immunosuppressed. This means that if you have an ostomy or a j-pouch and are not receiving any of the medications that affect the immune system, you are not considered to be at higher risk of developing COVID-19.
Vaccination
It is generally recommended that people who have IBD receive the vaccine to protect against COVID-19. There’s some evidence that having IBD may affect your immune response to the vaccine, and that immunity can be more effective after a booster.
People With IBD Diagnosed With COVID-19
If you are diagnosed with COVID-19, your doctor may make the call to stop your IBD medications. The IOIBD recommends restarting medication 14 days after the positive SARS-CoV-2 test, or after 2 nasal swabs are negative for SRS-CoV-2.If you have symptoms of COVID-19 and your doctor tells you to stop taking IBD medications, the IOIBD says you can restart again after the symptoms resolve.
These recommendations do not supersede your doctor’s advice. You might have more individualized instructions—depending on your overall health, the severity of your IBD, and the specific medications you’re taking.
A Word From Verywell
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit ourcoronavirus news page.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 pandemic: Expert commentary.Gastroenterology. 10 Apr 2020. [Epub ahead of print].doi:10.1053/j.gastro.2020.04.012IOIBD Taskforce: Dotan I, Panaccione R, Kaplan GG, O’Morain C, Lindsay J, Abreu MT. IOIBD recommendations:Best practice guidance for adult infusion centers during the COVID 19 pandemic. International Organization for the Study of IBD. 17 Apr 2020.Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease. Management of patients with Crohn’s disease and ulcerative colitis during the COVID-19 pandemic: Results of an international meeting.Gastroenterology. 2020 Apr 6. pii: S0016-5085(20)30465-0.doi:10.1053/j.gastro.2020.04.002[Epub ahead of print]Pape KA, Dileepan T, Matchett WE, Ellwood C, Stresemann S, Kabage AJ, Kozysa D, Evert C, Matson M, Lopez S, Krueger PD, Graiziger CT, Vaughn BP, Shmidt E, Rhein J, Schacker TW, Bold TD, Langlois RA, Khoruts A, Jenkins MK.Boosting corrects a memory B cell defect in SARS-CoV-2 mRNA-vaccinated patients with inflammatory bowel disease.JCI Insight. 2022 Jun 22;7(12):e159618. doi:10.1172/jci.insight.159618
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 pandemic: Expert commentary.Gastroenterology. 10 Apr 2020. [Epub ahead of print].doi:10.1053/j.gastro.2020.04.012IOIBD Taskforce: Dotan I, Panaccione R, Kaplan GG, O’Morain C, Lindsay J, Abreu MT. IOIBD recommendations:Best practice guidance for adult infusion centers during the COVID 19 pandemic. International Organization for the Study of IBD. 17 Apr 2020.Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease. Management of patients with Crohn’s disease and ulcerative colitis during the COVID-19 pandemic: Results of an international meeting.Gastroenterology. 2020 Apr 6. pii: S0016-5085(20)30465-0.doi:10.1053/j.gastro.2020.04.002[Epub ahead of print]Pape KA, Dileepan T, Matchett WE, Ellwood C, Stresemann S, Kabage AJ, Kozysa D, Evert C, Matson M, Lopez S, Krueger PD, Graiziger CT, Vaughn BP, Shmidt E, Rhein J, Schacker TW, Bold TD, Langlois RA, Khoruts A, Jenkins MK.Boosting corrects a memory B cell defect in SARS-CoV-2 mRNA-vaccinated patients with inflammatory bowel disease.JCI Insight. 2022 Jun 22;7(12):e159618. doi:10.1172/jci.insight.159618
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 pandemic: Expert commentary.Gastroenterology. 10 Apr 2020. [Epub ahead of print].doi:10.1053/j.gastro.2020.04.012IOIBD Taskforce: Dotan I, Panaccione R, Kaplan GG, O’Morain C, Lindsay J, Abreu MT. IOIBD recommendations:Best practice guidance for adult infusion centers during the COVID 19 pandemic. International Organization for the Study of IBD. 17 Apr 2020.Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease. Management of patients with Crohn’s disease and ulcerative colitis during the COVID-19 pandemic: Results of an international meeting.Gastroenterology. 2020 Apr 6. pii: S0016-5085(20)30465-0.doi:10.1053/j.gastro.2020.04.002[Epub ahead of print]Pape KA, Dileepan T, Matchett WE, Ellwood C, Stresemann S, Kabage AJ, Kozysa D, Evert C, Matson M, Lopez S, Krueger PD, Graiziger CT, Vaughn BP, Shmidt E, Rhein J, Schacker TW, Bold TD, Langlois RA, Khoruts A, Jenkins MK.Boosting corrects a memory B cell defect in SARS-CoV-2 mRNA-vaccinated patients with inflammatory bowel disease.JCI Insight. 2022 Jun 22;7(12):e159618. doi:10.1172/jci.insight.159618
Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 pandemic: Expert commentary.Gastroenterology. 10 Apr 2020. [Epub ahead of print].doi:10.1053/j.gastro.2020.04.012
IOIBD Taskforce: Dotan I, Panaccione R, Kaplan GG, O’Morain C, Lindsay J, Abreu MT. IOIBD recommendations:Best practice guidance for adult infusion centers during the COVID 19 pandemic. International Organization for the Study of IBD. 17 Apr 2020.
Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease. Management of patients with Crohn’s disease and ulcerative colitis during the COVID-19 pandemic: Results of an international meeting.Gastroenterology. 2020 Apr 6. pii: S0016-5085(20)30465-0.doi:10.1053/j.gastro.2020.04.002[Epub ahead of print]
Pape KA, Dileepan T, Matchett WE, Ellwood C, Stresemann S, Kabage AJ, Kozysa D, Evert C, Matson M, Lopez S, Krueger PD, Graiziger CT, Vaughn BP, Shmidt E, Rhein J, Schacker TW, Bold TD, Langlois RA, Khoruts A, Jenkins MK.Boosting corrects a memory B cell defect in SARS-CoV-2 mRNA-vaccinated patients with inflammatory bowel disease.JCI Insight. 2022 Jun 22;7(12):e159618. doi:10.1172/jci.insight.159618
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