జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Increased Self Medication with Steroids in Inflammatory Bowel Disease Patients During Covid-19 Pandemic: Time to Optimize Specialized Telemonitoring Services

Gautam Vinay

Inflammatory bowel disease (IBD) is a longstanding debilitating disease, which occurs due to complex interactions between genetic, environmental and inflammatory processes affecting the gut and other extra gastrointestinal systems. IBD includes Ulcerative Colitis (UC) and Crohn's Disease (CD), accompanied by frequent relapse and remissions. Facing the covid-19 pandemic has changed the current practice in IBD in terms of patient care and follow-up. Although, there is no current evidence that the SARS-CoV-2 virus exacerbates underlying IBD. In a recent meta-analysis of 24 studies, the risk of SARS-CoV-2 infection in IBD is found to be equivalent to that of the general population. However, when compared to CD, UC has a higher risk of negative adverse outcomes, especially on steroids. Discontinuing current medications for IBD such as 5- ASA, corticosteroids, immunomodulatory and biologic therapies due to various reasons may trigger disease flare, disability and dilemma to restart therapy. Steroids are effective non-selective anti-inflammatory, immunomodulatory, vasoconstrictive and anti-proliferative drugs.