Dr Kevin Barrett is a GP, working to improve awareness of Crohn's and Colitis among GPs. Kevin also has Crohn's Disease himself. Kevin has still been working as a GP during the coronavirus outbreak and here he offers his insight.
Covid-19, the coronavirus has had a large impact on healthcare for people living with Crohn’s and Colitis. Many hospitals have stopped doing almost all routine work so that wards and doctors, nurses and other healthcare professionals can be diverted to supporting and treating patients with coronavirus.
Endoscopy has been affected, but urgent and suspected cancer tests are still happening. It may be more difficult for people with Crohn’s and Colitis to have their regular blood tests and faecal calprotectin tests, a poo test to measure inflammation in the gut, are not being carried out as often. Some hospitals have stopped doing these for the time being. All patients, including those with Crohn’s or Colitis, who have a colonoscopy coming up will have their notes reviewed and will be written to if their colonoscopy can be delayed. If you have been given a date for a colonoscopy then please attend. Your IBD team will know your risk level and if it is safe to attend.
The symptoms of coronavirus can include abdominal pain and diarrhoea, and it can be difficult to know if these are the symptoms of a flare. If you are starting your journey to getting a diagnosis, please do not assume that any symptoms you may be experiencing are Covid-19. Any change in bowel habit that carries on for longer than a month should be investigated.
Although most GP surgeries have closed their doors and are telling patients to stay away, they are open and are working remotely with online, telephone and video advice. GPs and healthcare teams are visiting patients who cannot leave the house to carry out necessary medical care. Appointments with GPs and the rest of your primary healthcare team are relatively easy to access at the moment because of the cancellation of non-urgent and routine work. If you have symptoms that you are concerned about, please get in touch with your GP practice. If you have a medical emergency, do not be afraid to call 999 and please do still go to A&E if you need to.
We understand it might feel scary to visit a hospital during lockdown, but it is important that if you are worried about your Crohn’s or Colitis you don’t just brush it off and wait.
Healthcare professionals are concerned about patients who are not seeking attention for symptoms that could indicate cancer or serious illness, including Crohn’s and Colitis, and the impact that a delay in diagnosis can have. If you are worried about a symptom that isn’t going away, please get in touch with your GP.
If you’re on medication, a lot has been written about the risks versus benefits of immunosuppressants. Almost every person with Crohn’s or Colitis will be at a lower risk of Covid-19 if you continue your prescribed medication than if you stop or reduce your dose against medical advice and then suffer a flare. The one exception to this is patients taking high dose prednisolone, and these patients should have had a discussion with their IBD team about their risk. Patients should not stop prednisolone or any other steroid suddenly.
If you’re still not sure on your risk level, the best place to find out this information is on the Crohn’s & Colitis UK website. Crohn’s & Colitis UK have been working closely with the British Society of Gastroenterology (BSG) - a UK professional membership body which consists of most of the Gastroenterology Specialists in the country along with nurses and other health care professionals – to produce this.
The advice regarding Covid-19 continues to evolve as more information emerges but for now the situation is settling. It looks like we will be stuck in some form of lockdown for several months. Primary and secondary care are working together to produce further guidance as we start to enter the recovery phase and face the “new normal” world of healthcare.
Things won’t be the same but we will try to keep the positive parts of the changes that have happened and combine this with previous best-practice.
As the BSG said “Take care of yourself but also be kind and considerate to others in these difficult times”
The information we provide to people living with Crohn's and Colitis provides much needed support to our NHS, which is under immense pressure. If you can, please help us continue this vital work.