Your UC Treatment Plan During COVID
Safety is paramount, but so is your health. Here’s how to have the best of both.
For the roughly one million people in the U.S. living with ulcerative colitis (UC), creating a solid plan for consistent care and sticking with it can mean the difference between slaying the day-to-day like a boss or constantly worrying whether a bathroom is nearby. Here’s the lowdown: UC is a chronic inflammatory bowel condition, which affects the lining of the colon and rectum (the parts that make up the large intestine) and can cause small sores or ulcers to form. “What’s happening is the immune system goes into a mistaken response and fights the colon,” says Praveen Guturu, M.D., FACG, a gastroenterologist with Gastro Health in Seattle. When the colon becomes inflamed, it can cause symptoms like stool urgency, fatigue, frequent diarrhea, mucus in the stool, bloody stool, and abdominal pain, which can get worse over time, he says.
Because UC is a chronic and often unpredictable condition, it won’t go away, but when you find (and stay on!) the right meds and check in with your doc regularly, it can become asymptomatic during periods of remission (these can span months or even years). However, every GI doc on the planet will tell you that even during times of remission it’s still important to continue taking your meds and going in for checkups. Which, in theory, all sounds like an easy plan during normal circumstances. Now throw in COVID, which has everyone avoiding doctor’s appointments like the plague and lapsing on regular care—a big no-no for anyone with IBD. To ease your angst, here’s what you need to know about routine care in the face of COVID.
See Your Doc. Yes, In Person.
Hopefully, you’re going along taking care of yourself like clockwork and the condition is in remission. If this is, in fact, the case, you should typically see your physician once every six months—particularly to monitor bloodwork and make sure there are no side effects from your meds, says Siobhan Proksell, M.D., a gastroenterologist with the University of Miami Health System and assistant professor of clinical medicine at the University of Miami Miller School of Medicine. However, if you’re experiencing a flareup or having any new signs or symptoms, an in-person physical exam is necessary and should be done without delay. “We need to see someone in person, because there are things that you cannot do without a rectal or abdominal exam,” Dr. Guturu says.
Feel Confident in Safety Measures
We totally get you may have fears about in-person doctor’s appointments. But know this: Offices are putting every safety measure under the sun into regular protocol to kick the threat of COVID to a faraway curb. While every practice may have a slight variation in procedure (and you should call your own doc’s office to find out theirs), many, like the University of Miami Health System, are giving patients symptom-screening questionnaires even before entering the building, and administering temperature checks upon arrival, Dr. Proksell says. “Waiting rooms are set up in such a way that allow for patients to maintain adequate distance while waiting, staff are masked and maintaining appropriate social distance whenever possible, and each clinic room and associated equipment is be thoroughly cleaned after each patient visit,” she says. And what’s more, there’s the vaccine (praise!). “Healthcare providers have priority to receive the COVID-19 vaccine and the majority have already done so, further ensuring protection for both patient and provider,” Dr. Proksell says.
Mind Your Meds
Staying the course of your regular meds is super important for avoiding flareups and further complications of ulcerative colitis, Dr. Proksell says. “Based on studies thus far, IBD patients have not been shown to have an increased susceptibility to COVID-19 nor have the medications used to treat ulcerative colitis been found to have a negative impact on outcomes of patients with COVID,” she says. There is one caveat, however. According to researchers, IBD patients on immunosuppressive medications are, in general, more susceptible to infection. Specifically, being on steroids or immunomodulators can increase an IBD patient's risk for viral infections. However, docs agree having active inflammation is a bigger risk for infection than being on your meds and being off meds places you at risk for a relapse. So, the consensus from the medical community is to stay your recommended course. “If you do become infected with COVID-19, contact your gastroenterologist, as we may adjust the timing of, or briefly hold, therapy if you are ill,” Dr. Proksell says.
- All About UC: StatPearls. (2021). “Ulcerative Colitis.” ncbi.nlm.nih.gov/books/NBK459282/
- UC & COVID: Hopkins Medicine. “IBD Patient Guidance: COVID-19.” hopkinsmedicine.org/inflammatory_bowel_disease_center/covid-19-guidance.html
- Guidelines for IBD Care During COVID: Journal of Crohn’s and Colitis. (2020). “Inflammatory Bowel Disease Management During the COVID-19 Outbreak: The Ten Do’s and Don’ts from the ECCO-COVID Taskforce.” academic.oup.com/ecco-jcc/article/14/Supplement_3/S798/5877458