IBD-SSHAMP (Inflammatory Bowel Disease – Supported, Self Help and Management Programme); UK’s first internet based remote management system for managing stable IBD, was recently highlighted on the NHS Networks Primary Care Transformation platform

Click here to see a link

This year they are keen to set up a Functional Gut Clinic, with the support of a range of services such as Radiology, Endoscopy, Immunology, Capsule and Dietetics

They have started the new year with this video flier in which I discuss some of the basic principals

Click on this Video HyperLink to watch

Essentially they have made 5 recommendations

RECOMMENDATION 1: We strongly support SARS-CoV2 vaccination for patients with IBD.

RECOMMENDATION 2: The risks of SARS-CoV2 vaccination in IBD patients are anticipated to be very low.

RECOMMENDATION 3: In IBD patients taking immunosuppressive drugs, including biologics and small molecule inhibitors, the key concerns are related to the theoretical risk of sub-optimal vaccine responses rather than vaccine side effects.

RECOMMENDATION 4: We recommend that IBD patients accept whichever approved SARS-CoV2 vaccination is offered to them, in accordance with UK Department of Health and Social Care and the Medicines and Healthcare products Regulatory Agency (MHRA)

RECOMMENDATION 5: It is important that patients with IBD are offered consistent and unbiased advice. This will be disseminated through the BSG and Crohnâ€s & Colitis UK.

Click on this link to read more.

What is not so clear, is the optimal timing of the vaccinations. There has not been any specific recommendations, but locally (at the L&D) we are recommending that anyone on Biological therapy has this placed mid-way through their infusion cycle (ie. If you receive Infliximab every 2 months we would suggest you plan to have your vaccination at the 1 month mid-point). This should avoid the peak of the immunosuppressive effect, whilst also leaving a suitable gap for the vaccination to induce its desired immune response.

To the best of my knowledge coeliac disease does not carry any additional risks to;-

1. Picking up corona virus, or 
2. Suffering from it, if you were unfortunate enough to contract it.

This is also the case for those patients with coeliac disease and hyposplenism. 

I have recently heard of some patients receiving letters stating;-

“NHS Coronavirus Service: Your condition means you are at high risk of severe illness if you catch Coronavirus. Please remain at home for 12 weeks unless a healthcare professional tells you to leave. You will get a letter from the NHS to confirm this.” This is called shielding.

It is possible these people may have received these letters for other medical reasons, rather than this being specifically due to their coeliac disease. 1 in 100 people in UK are believed to have coeliac disease so some may have received these letters if they have other associated immunodeficiencies or are taking immunomodulator therapy for other conditions

Presently I would therefore continue to advise you on (stringent) social distancing. The latest government advice is that we should all stay at home and only go outside when it is essential. This advice applies to everyone, whether or not you have coeliac disease.  

Until things change I would recommend following the Coeliac UK guidance and advice provided by Government contained in the link below.  

https://www.coeliac.org.uk/information-and-support/coeliac-disease-and-coronavirus-covid-19/

In essence this states; – ” The government has also provided advice on shielding for people defined as extremely vulnerable from COVID-19. People with coeliac disease (including those who have problems with their spleen) who have no other health conditions do not fall into this category. If you fall into this category you should receive a letter by Sunday 29 March 2020. The Government website has more information on shielding.”

Keep safe 

Dr. Matt W. Johnson. BSc MB BS FRCP MD