Endoscopy in inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is changing the management of many chronic diseases, including that of patients with inflammatory bowel diseases (IBD). In particular, the performance of routine endoscopy is temporarily suspended, and only emergency endoscopy is allowed in many countries where severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread. We highlight different scenarios in which endoscopy should still be performed urgently in patients with IBD, as well as recommendations regarding the use of personal protective equipment. We suggest a pathway for performing safe endoscopy and discuss the potential risks of postponing endoscopy in IBD. Finally, we propose a post-pandemic plan for access to endoscopy.

Addendum to S3-Guidelines Crohn’s disease and ulcerative colitis: Management of Patients with Inflammatory Bowel Disease in the COVID-19 Pandemic – open questions and answers

“…Alternatively, endoscopic examinations of patients with COVID-19 can be performed in operating theatres (with negative pressure). Some professional societies and authors have already addressed the question of how to proceed with endoscopic examinations after the pandemic [90][91][92]. Most favour a risk-adapted, gradual return to normal operation ("new normal").…”

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

“…During the lockdown until to the flattening of the pandemic curve, endoscopic examinations have been drastically reduced and limited only to the not deferrable cases. 49 , 50 Currently, with the containment of the pandemic, the previously not performed endoscopies should be rescheduled. This scenario inevitably implies a very delicate and demanding task consisting in the shift from an open access endoscopy to a filtered access.…”

Addendum zu den S3-Leitlinien Morbus Crohn und Colitis ulcerosa: Betreuung von Patienten mit chronisch entzündlichen Darmerkrankungen in der COVID-19-Pandemie – offene Fragen und Antworten

“…Einige Fachgesellschaften bzw. Autoren haben sich bereits mit der Frage beschäftigt, wie es nach der Pandemie mit endoskopischen Untersuchungen weitergeht [90][91][92]. In der Regel wird eine risikoadaptierte, stufenweise Rückkehr zum Normalbetrieb ("neue Normalität") favorisiert.…”