You might be wondering if you need to stop taking your ulcerative colitis medicines.
People who live with chronic conditions like ulcerative colitis know that their treatments may come with some risks. For example, while ulcerative colitis treatments help manage symptoms and prevent complications, they can also affect the immune system. Are people with ulcerative colitis in danger if they get COVID-19? What should they do after getting the test results?
These treatment decisions can be tricky. COVID-19 can potentially lead to a flare of ulcerative colitis, leading to symptoms like rectal bleeding, diarrhea, and abdominal pain. This can make the experience of COVID-19 even more challenging and unpleasant. After all, COVID-19 sometimes comes with its own set of difficult symptoms.
COVID-19 with Ulcerative Colitis: What to Do
Ideally, you should have a conversation with your doctor before getting COVID-19. Talk about your risk for COVID-19, and make a plan for how to manage your risk.
Either way, once you’ve gotten that positive COVID-19 test result, reach out to your doctor. Together, you should take a look at your ulcerative colitis treatments and decide if you should continue taking them while you have active COVID-19. The main thing you and your doctor will need to consider is glucocorticoids.
Glucocorticoids are steroids that help lower inflammation and reduce symptoms during a flare of ulcerative colitis. They can be very helpful at managing flares. However, they do suppress the immune system and increase your risk of having a severe case of COVID-19.
If you are currently taking glucocorticoids when you learn you have COVID-19, you and your doctor should discuss the risks and benefits of continuing your glucocorticoid therapy. Continuing the therapy could put you at risk of severe COVID-19, but stopping the therapy could lead to another ulcerative colitis flare. There’s not a “right” answer here: It’s an individualized decision based on your unique situation and risk factors.
What About Biologics?
Many people with ulcerative colitis are on biologics to manage their condition. While glucocorticoids suppress the entire immune system, biologics only target specific parts of the immune system that are known to cause ulcerative colitis activity.
Luckily, biologics don’t appear to have a significant effect on your COVID-19 risk. In fact, they may even be beneficial because they may help prevent the need for glucocorticoids. Your doctor will likely recommend that you continue taking your biologic while you have COVID-19, unless there are extenuating circumstances. Again, this is a conversation to have with your doctor.
Like anyone else who gets a COVID-19 diagnosis, it’s always good to talk to your doctor about potential signs of an emergency. Many people can recover from COVID-19 at home, but you should call your doctor if you start noticing warning signs of severe COVID-19, including difficulty breathing.
Dr. Kayal is a gastroenterologist at Icahn School of Medicine at Mount Sinai.
- COVID-19 (coronavirus): what IBD patients should know. Crohn’s & Colitis Foundation, 2021. (Accessed on July 15, 2021)
- COVID-19: Issues related to gastrointestinal disease in adults. Waltham, MA: UpToDate, 2021. (Accessed on July 15, 2021)
- COVID-19: symptoms. Atlanta, GA: Centers for Disease Control and Prevention, 2021. (Accessed on July 15, 2021)
- IBD patient guidance. Crohn’s & Colitis Foundation. (Accessed on July 15, 2021)
- Management of moderate to severe ulcerative colitis in adults. Waltham, MA: UpToDate, 2021. (Accessed on July 15, 2021)