Impact of COVID-19 on diagnosis and management of paediatric inflammatory bowel disease during lockdown: a UK nationwide study

BackgroundCOVID-19 has impacted on healthcare provision. Anecdotally, investigations for children with inflammatory bowel disease (IBD) have been restricted, resulting in diagnosis with no histological confirmation and potential secondary morbidity. In this study, we detail practice across the UK to assess impact on services and document the impact of the pandemic.MethodsFor the month of April 2020, 20 tertiary paediatric IBD centres were invited to contribute data detailing: (1) diagnosis/management of suspected new patients with IBD; (2) facilities available; (3) ongoing management of IBD; and (4) direct impact of COVID-19 on patients with IBD.ResultsAll centres contributed. Two centres retained routine endoscopy, with three unable to perform even urgent IBD endoscopy. 122 patients were diagnosed with IBD, and 53.3% (n=65) were presumed diagnoses and had not undergone endoscopy with histological confirmation. The most common induction was exclusive enteral nutrition (44.6%). No patients with a presumed rather than confirmed diagnosis were started on anti-tumour necrosis factor (TNF) therapy.Most IBD follow-up appointments were able to occur using phone/webcam or face to face. No biologics/immunomodulators were stopped. All centres were able to continue IBD surgery if required, with 14 procedures occurring across seven centres.ConclusionsDiagnostic IBD practice has been hugely impacted by COVID-19, with >50% of new diagnoses not having endoscopy. To date, therapy and review of known paediatric patients with IBD has continued. Planning and resourcing for recovery is crucial to minimise continued secondary morbidity.

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Insight from patients and healthcare professionals on the implementation of virtual clinics in patients with inflammatory bowel disease

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101714 ◽

2021 ◽

pp. flgastro-2020-101714

Author(s):

Aditi Kumar ◽

Mohammed Nabil Quraishi ◽

Shanika de Silva ◽

Nigel John Trudgill ◽

Helen Steed ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Healthcare Professionals ◽

Telephone Consultation ◽

Face To Face ◽

Short Answer ◽

Inflammatory Bowel ◽

The Uk ◽

Short Answer Questions ◽

The Impact

IntroductionDuring COVID-19, the management of outpatient inflammatory bowel disease (IBD) changed from face-to-face (F2F) to telephone and video consultations across the UK. We surveyed patients with IBD and IBD healthcare professionals (HCPs) to evaluate the impact of this abrupt transition on patient and HCP satisfaction outcomes, including the barriers and enablers of this service.MethodsPatient satisfaction surveys were sent to patients who had a telephone consultation from May to July 2020. A second survey was sent to IBD HCPs across the UK. Questions from both surveys consisted of a mixture of multiple-choice options, ranking answers as well as short-answer questions.Results210 patients and 114 HCPs completed the survey. During COVID-19, there was a significantly greater use of telephone, video or a mixture of consultation. F2F consultations were consistently preferred by patients, with 50% of patients indicating they did not want the option of for video consultations. Patients were more likely to prefer a telephone consultation if they were stable and needed routine review. Significantly fewer HCPs (5.3%) intend to use F2F consultations alone, preferring the use of telephone (20.2%) or combinations of telephone/F2F (22.8%), telephone/video (4.4%) or combination of all three consultation types (34.2%). 63% indicated they intend to incorporate video consultations in the future.ConclusionTelephone and video consultations need to be balanced proportionately with F2F clinics to achieve both patient and HCP satisfaction. Further research needs to be done to explore the use of video medicine in patients with IBD.

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P136 Management of patients with Inflammatory Bowel Disease and their outcome during the first wave of Covid-19 pandemics

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.263 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S223-S224

Author(s):

A Viola ◽

F Giambò ◽

M F Chiappetta ◽

G Costantino ◽

S Pallio ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Secondary Outcome ◽

Reference Period ◽

Disease Flare ◽

Face To Face ◽

Risk Of Disease ◽

Inflammatory Bowel ◽

Group 2 ◽

The Impact

Abstract Background The restrictions adopted in Italy during the phase I COVID-19 pandemics with a nationwide lockdown period, represented a challenge in the management of Patients with Inflammatory Bowel Disease (IBD) patients. The aim of the present study was to assess if, and how, a limited course of telemedicine did influence the clinical outcome in patients with Crohn’s disease (CD) and Ulcerative Colitis (UC). Methods IBD patients followed before March 8th, 2020 were included and divided into 3 groups (Fig.1): group 1, patients on endovenous biologics (EV); group 2, patients on biologics administered subcutaneously (SC); and group 3, patients on conventional treatments (CT) at the start of lockdown. The primary outcome was to assess the occurrence of disease flare in the three groups since only the EV group received face-to-face visits during lockdown. As secondary outcome we assessed the number of control endoscopies performed and the start of new biologic therapies, compared with a reference period in 2019. Results A total of 689 patients (CD: 369, UC 320) were included in the study (247 IV, 217 SC and 225 CT, respectively). Telemedicine was more frequently adopted in SC and CS, (p<0.001) both. Treatment delays or transitory stops were more frequent in EV (p<0.001), whereas there was a significantly greater need to change therapy (p= 0.038) and need for steroids (p = 0.008) in the SC group compared with EV (Tab.1). Concerning endoscopies, compared with the reference period in 2019 only 25% of scheduled endoscopies were performed. The only risk factor for disease flare during or shortly after lockdown was belonging to the patient groups subjected to telemedicine (SC and CT groups) (p < 0.001). Conclusion Patients followed with a face-to-face approach instead of telemedicine, had a lower risk of disease flare during lockdown period. The impact of the important reduction of endoscopic assessments still needs to be assessed.

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Specialist inflammatory bowel disease nursing in the UK: current situation and future proofing

Frontline Gastroenterology ◽

10.1136/flgastro-2019-101354 ◽

2020 ◽

pp. flgastro-2019-101354 ◽

Cited By ~ 1

Author(s):

Lisa Younge ◽

Isobel Mason ◽

Rukshana Kapasi

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Formal Education ◽

Clinical Nurse Specialists ◽

Nursing Services ◽

Business Cases ◽

Inflammatory Bowel ◽

Specialist Nurses ◽

The Uk ◽

The Impact

ObjectiveTo determine the impact to date of the ongoing Crohn’s & Colitis UK inflammatory bowel disease (IBD) clinical nurse specialists (CNS) campaign.MethodsA survey-based design was used. 2 questionnaires were sent to the UK IBD nursing community and promoted via nursing and clinical networks. Respondents were asked to provide data at both an individual and trust level about their nursing services.Results394 IBD CNS posts were identified across the UK, with a 32% increase in posts since the start of the campaign. 27% felt the campaign had been influential in securing new posts. Greater numbers of posts were reported in England when compared with the devolved nations. Most services remain below the UK standards recommendation of 2.5 IBD CNS per 250 000 patient population. Cross site working was reported in 59% of services. 45% of respondents were non-medical prescribers, with 13% educated to MSc level. High levels of stress were reported by IBD CNS associated with managing advice line services.ConclusionsCrohn’s & Colitis UK’s ‘More IBD Nurses–Better Care’ campaign has contributed to the numbers of CNS posts in IBD continuing to rise, but they remain lower than the recommended standard of 2.5 IBD CNS per 250 000. Educational and career pathways are not clearly defined, and aspects of the role such as advice line provision contribute to stress within the workforce. The ongoing aims of the charity campaign hope to address these issues by improving access to formal education pathways with peer support for IBD specialist nurses, and advice line training, in addition to supporting trusts and services throughout the UK to reduce the workforce deficit with effective business cases.

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Incisional hernia repair by synthetic mesh prosthesis in patients with inflammatory bowel disease: a comparative analysis

BMC Surgery ◽

10.1186/s12893-021-01350-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel Heise ◽

Charles Schram ◽

Roman Eickhoff ◽

Jan Bednarsch ◽

Marius Helmedag ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Risk Factor ◽

Hernia Repair ◽

Bowel Disease ◽

Hernia Recurrence ◽

Postoperative Course ◽

Major Complications ◽

Inflammatory Bowel ◽

The Impact

Abstract Background Patients with inflammatory bowel disease (IBD) have a high-life time risk undergoing abdominal surgery and are prone to develop incisional hernias (IH) in the postoperative course. Therefore, we investigated the role of IBD as perioperative risk factor in open ventral hernia repair (OVHR) as well as the impact of IBD on hernia recurrence during postoperative follow-up. Methods The postoperative course of 223 patients (Non-IBD (n = 199) and IBD (n = 34)) who underwent OVHR were compared by means of extensive group comparisons and binary logistic regressions. Hernia recurrence was investigated in the IBD group according to the Kaplan–Meier method and risk factors for recurrence determined by Cox regressions. Results General complications (≥ Clavien-Dindo I) occurred in 30.9% (72/233) and major complications (≥ Clavien-Dindo IIIb) in 7.7% (18/233) of the overall cohort with IBD being the single independent risk-factor for major complications (OR = 4.2, p = 0.007). Further, IBD patients displayed a recurrence rate of 26.5% (9/34) after a median follow-up of 36 months. Multivariable analysis revealed higher rates of recurrence in patients with ulcerative colitis (UC, 8/15, HR = 11.7) compared to patients with Crohn’s disease (CD, 1/19, HR = 1.0, p = 0.021). Conclusion IBD is a significant risk factor for major postoperative morbidity after OVHR. In addition, individuals with IBD show high rates of hernia recurrence over time with UC patients being more prone to recurrence than patients with CD.

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P503 Inflammatory bowel disease video-consulting: a satisfaction survey during the second wave of Covid-19 pandemics

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.625 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S486-S486

Author(s):

A Todeschini

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Clinical Issue ◽

Face To Face ◽

Degree Of Satisfaction ◽

Inflammatory Bowel ◽

High Degree ◽

Second Wave ◽

Substantial Change

Abstract Background During the SARS-CoV-2 pandemic there was a substantial change in providing medical care. National and international statements recommended avoiding face-to-face visit for treatment of patients especially for chronic disease. Also lockdown and social distancing cause a lot of concern among patients, which prefer avoid hospital facilities due to fear of contracting COVID-19. For these reason there was a reorganization of inflammatory bowel disease follow-up visit shifting from traditional visit to telemedicine whereas it’ was possible. Our survey aimed to evaluated satisfaction about follow up video-consulting in IBD patients. Methods From September to December 2020, 75 video-consults were made as follow up in patients with IBD. Video-consult wasn’t performed as first visit nor in patients with new clinical issue. Every consult lasted about 15 minutes. At the end of the visit, a questionnaire of satisfaction was e-mailed to each patient. This questionnaire evaluated several items: satisfaction, difficulty of connection, opportunity to repeat the video-consult even in post-Covid-19 era, safety compared to face-to-face visit, level of concern about Covid-19 disease and fear of in-hospital transmission Results 70% of the patients indicated an high video-consult rating and in most of cases (88%) there were no connection problems. The majority (88%) would like to repeat the tele-visit even in the post-Covid 19 era (77%). Video-consult seemed to be perceived as safer than face-to-face visit even if, in case of urgent consultation, it was preferred a traditional visit. Moreover, Covid-19 infection and fear of in-hospital trasmission was a great concern in the 73% and 58% of the patients respectively. Conclusion In our survey, outpatients reported a very high degree of satisfaction with video consultations. It was an easy and safe tool that may become an integral part of clinical practice in the future.

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N19 Understanding the emotional impact of inflammatory bowel disease: looking after nurses looking after patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.1002 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S666-S666

Author(s):

L Younge ◽

L Medcalf ◽

A Hall ◽

C Shaw

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Psychological Impact ◽

Well Being ◽

Emotional Impact ◽

Learning Needs ◽

Emotional States ◽

Inflammatory Bowel ◽

The Uk ◽

The Impact

Abstract Background The emotional impact of inflammatory bowel disease (IBD) is well documented. Patients describe distress, anxiety, depression and relationship difficulties, (including with healthcare staff). Nurses working with IBD patients report being emotionally affected, with fears of ‘burnout’, feeling unable to respond helpfully to patients and feelings of guilt, frustration, sadness and anger. Understanding and managing the emotional impact of the work for IBD nurses is an area underrepresented in either research or nursing literature. Methods A collaborative project with IBD nurses and nursing and psychotherapy colleagues from the Tavistock and Portman NHS Foundation Trust developed a one-day event for IBD nurses in the UK. Attendees were self-selecting and the event was supported by Pharma. The conference had three aims: To provide an opportunity to recognise and understand the emotional impact on nurses working with IBD patients, to provide a networking opportunity, and to use information gathered before, during and after the conference to develop a clearer understanding of nurses’ experiences and needs. A pre-conference questionnaire was sent to attendees, observations were made during the conference (noting themes and dilemmas) and an evaluation form was provided. Results 89% agreed/strongly agreed the event provided understanding of how IBD can have an emotional and psychological impact on patients. 89% agreed/strongly agreed the event provided understanding of the emotional impact on nurses working with IBD patients. Eighty-nine per cent agreed/strongly agreed the event provided understanding of ways in which the emotional impact can influence provision of care and decision making in patients with IBD. Ninety-three per cent agreed/strongly agreed the event provided them with ideas for establishing and managing reflective learning opportunities. Seventy-five per cent agreed/strongly agreed the event enabled them to identify different ways of responding to patients they work with. Conclusion Feedback from attendees identified a need and an expressed wish by IBD nurses to understand and explore how they are affected by their work, in relation to maintaining therapeutic and safe relationships with patients and maintaining their own well-being and job satisfaction. Learning needs relating to training in supervision, developing skills in responding to patients’ emotional states, tools for looking after one’s self and opportunities for group discussions and learning were identified. There is an opportunity to develop further learning and training events in relation to these identified needs. Further exploration of accessibility, funding and evaluation would be beneficial in identifying the impact, if any, of further training.

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A249 FREQUENCY AND CLINICAL SIGNIFICANCE OF INFLAMMATORY BOWEL DISEASE IN PATIENTS WITH AUTOIMMUNE HEPATITIS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.248 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 126-127

Author(s):

E Lytvyak ◽

L A Dieleman ◽

A J Montano-Loza

Keyword(s):

Inflammatory Bowel Disease ◽

Autoimmune Hepatitis ◽

Median Time ◽

Bowel Disease ◽

Cox Regression ◽

Age At Diagnosis ◽

Response To Treatment ◽

Inflammatory Bowel ◽

The Impact

Abstract Background Previous studies suggested that patients with autoimmune hepatitis (AIH) and inflammatory bowel disease (IBD) have poorer outcomes; however, the significance of this association is limited. Aims To describe the phenotype of AIH-associated IBD and assess the impact of IBD on the response to treatment and risk of adverse liver outcomes in patients with AIH. Methods In our retrospective cohorts, we identified patients with concomitant diagnoses of IBD and a definite AIH. The comparison cohort consisted of AIH patients matched by gender, age at diagnosis, ethnicity, and time to follow-up. Chi-square and Mann-Whitney tests were used to assess differences. Univariate analysis was performed using the Cox proportional hazards model. Results We identified a total of 16 patients (9 males, 56.3%) with AIH-associated IBD from a cohort of 6006 IBD patients (0.27%) and 357 AIH patients (4.5%). All patients were Caucasians. Twelve patients (75.0%) had ulcerative colitis with a pancolonic extent; 4 (25.0%) – Crohn’s disease: one patient had ileitis, three – ileocolitis with one having stricturing and fistulising gastroduodenal, ileocolonic and perianal disease. The median age at IBD diagnosis was 26.5 years old and varied from 2 to 53. The age at AIH diagnosis ranged from 7 to 59 years old (median 21.1) and median follow-up time was 11.1 years ranging from 11 days to 35.2 years. The matching cohort of 113 AIH-IBD- patients was comparable to the AIH-IBD+ cohort by gender (44 males, 38.9%; p=0.188), age at diagnosis (median 28.4, IQR 32; p=0.442), ethnicity, and the follow-up time (median 8.7 years, IQR 10.2; p=0.764). There was no difference in AST, ALT and ALP at diagnosis. Complete response rates were similar in AIH-IBD+ and AIH-IBD- groups (50.0% vs. 53.1%; p=0.816). The risk of developing cirrhosis and a median time to its onset did not differ significantly: 28.6% vs. 31.0% (p=0.853) and 11.8 vs. 8.2 years (p=0.359), respectively. In univariate Cox regression, IBD was not a predictor of progression to cirrhosis (HR 0.45; 95% CI 0.13–1.50; p=0.192). The risk of developing decompensation and a median time was also comparable between groups: 21.4% vs. 33.0% (p=0.384) and 18.4 vs. 9.8 years (p=0.053), supported by the Cox regression analysis (HR 0.44; 95% CI 0.13–1.48; p=0.187). The presence of IBD was not associated with higher need in liver transplant (18.8% vs. 30.1%; p=0.348), median time was slightly shorter (1.48 vs. 4.73 years; p=0.542), also evidenced by Cox regression (HR 1.40; 95% CI 0.42–4.65; p=0.578). The risk of liver-related death was also not different among the two groups (6.3% vs. 4.4%; p=0.746), and IBD was not a predictor of it (HR 1.94; 95% CI 0.17–21.69; p=0.589). Conclusions The presence of IBD in patients with AIH is rare and do not identify a subgroup of patients with worse response to treatment or poor clinical outcomes. Funding Agencies AbbVie

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P312 Introduction of bowel ultrasonography for follow-up of paediatric inflammatory bowel disease: A single-centre experience

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.441 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S310-S310

Author(s):

R Lev Zion ◽

G Focht ◽

N Asayag ◽

D Turner

Keyword(s):

Decision Making ◽

Inflammatory Bowel Disease ◽

Wall Thickness ◽

Bowel Disease ◽

Clinical Decision Making ◽

Clinical Decision ◽

Wall Thickening ◽

Inflammatory Bowel ◽

The Impact

Abstract Background Bowel ultrasonography (BUS) for imaging of inflammatory bowel disease (IBD) is increasingly recognised as a prominent non-invasive tool to supplement, and in some cases replace traditional endoscopic and imaging modalities, with high sensitivity and specificity. The increasing number of gastroenterologists trained to perform BUS has transformed BUS into a bedside tool to guide routine clinical decision making and accurately monitor response to treatment. However, this process is still in its infancy in paediatric IBD. We present here data on the first 2 years of implementation of BUS performed by a paediatric gastroenterologist (RLT) at the paediatric IBD centre at Shaare Zedek Medical Center in Jerusalem. We aim to describe trends, results and clinical implications of the US studies performed during this period. Methods The electronic medical record system was searched for all BUS studies performed on IBD patients by RLT as part of his weekly IBD clinic between 2017–2019. Studies performed on other caregivers’ patients were excluded to ensure uniform documentation and nomenclature. Findings were classified as normal (wall thickness <3 mm), mild (wall thickening 3–4 mm and blood flow < Limberg 3) or significant signs of inflammation (wall thickness ≥4 mm or 3–4 mm with Limberg ≥3). Charts were reviewed to assess the impact of BUS findings on clinical management. Results A total of 83 bedside BUS studies were performed on 55 IBD patients (42 with Crohn’s – CD) during the study period, with a mean age of 15.1 ± 3.7 years. Thirty-four had one study (23 with CD), 15 had two (13 with CD) and 6 had three or more (all with CD). Overall, 32 studies were normal, 20 showed mild findings and 30 showed significant inflammation. Four studies found stenosis and one showed an abscess. Follow-up studies of initially active disease showed 10/16 (63%) with improvement, including 9/16 (56%) with sonographic remission. 22/83 (27%) studies were felt upon review to have had a direct impact on clinical decision-making. These included decisions not to switch therapy due to normal BUS despite symptoms, admission due to discovery of an abscess, decision to escalate therapy due to lack of sonographic improvement, and decision to continue adalimumab in the presence of a stricture due to favourable prognostic characteristics as per the CREOLE study. Conclusion Bedside BUS is a practical and useful tool that can be integrated into a paediatric IBD clinic, with the ability to provide relevant information in real-time and thus impact on day-to-day patient management.

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COVID-19-related health anxieties and impact of specific interventions in patients with inflammatory bowel disease in the UK

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101633 ◽

2020 ◽

pp. flgastro-2020-101633

Author(s):

Nasir Mir ◽

Jonathan Cheesbrough ◽

Thomas Troth ◽

Nasir Hussain ◽

Laurence Joseph Hopkins ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Information Seeking ◽

Information Dissemination ◽

Risk Groups ◽

Health Related ◽

Inflammatory Bowel ◽

The Uk ◽

Clinical Interactions ◽

The Impact

ObjectiveHealth-related concerns brought on by the COVID-19 pandemic and the impact of specific local and national interventions have not been explored in patients with inflammatory bowel disease (IBD) in the UK. We evaluated perspectives of patients with IBD on the pandemic and effectiveness of information dissemination in addressing concerns.MethodsWe prospectively conducted a survey among patients with IBD during the COVID-19 pandemic to assess concerns, information-seeking behaviours, risk perception, compliance and effect of specific interventions.ResultsA total of 228 patients were interviewed of whom 89% reported being concerned about the impact of COVID-19 on their health. Access to at least one IBD-specific clinical interaction during the pandemic (COVID-19 information letter from IBD team, interaction with IBD team or general practitioner, Crohn and Colitis UK website visit) was significantly associated with alleviating concerns (OR 2.66; 95% CI 1.35 to 5.24; p=0.005). Seeking health information solely through unofficial channels (search engines or social media) was less likely to ease concerns (OR 0.15; 95% CI 0.03 to 0.61; p=0.008). A quarter of patients disagreed with their assigned risk groups, with majority perceiving higher-risk profiles. This discordance was greatest in patients within the moderate-risk group and constituted immunosuppression use. Nearly 40% of patients had ongoing concerns with regard to their medications of whom a third felt their concerns were not addressed.ConclusionIBD-specific clinical interactions are associated with alleviation of COVID-19 health concerns. These findings have wider implications and emphasise importance of innovative solutions that facilitate effective communication with patients without overburdening current services.

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Organisational changes and challenges for inflammatory bowel disease services in the UK during the COVID-19 pandemic

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101520 ◽

2020 ◽

Vol 11 (5) ◽

pp. 343-350 ◽

Cited By ~ 3

Author(s):

Nicholas A Kennedy ◽

Richard Hansen ◽

Lisa Younge ◽

Joel Mawdsley ◽

R Mark Beattie ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Elective Surgery ◽

Quality Care ◽

Faecal Calprotectin ◽

Telephone Consultation ◽

Ensure Patient Safety ◽

Inflammatory Bowel ◽

The Uk ◽

The Impact

ObjectiveTo determine the challenges in diagnosis, monitoring, support provision in the management of inflammatory bowel disease (IBD) patients and explore the adaptations of IBD services.MethodsInternet-based survey by invitation of IBD services across the UK from 8 to 14 April 2020.ResultsRespondents from 125 IBD services completed the survey. The number of whole-time equivalent gastroenterologists and IBD nurses providing elective outpatient care decreased significantly between baseline (median 4, IQR 4–7.5 and median 3, IQR 2–4) to the point of survey (median 2, IQR 1–4.8 and median 2, IQR 1–3) in the 6-week period following the onset of the COVID-19 pandemic (p<0.001 for both comparisons). Almost all (94%; 112/119) services reported an increase in IBD helpline activity. Face-to-face clinics were substituted for telephone consultation by 86% and video consultation by 11% of services. A variation in the provision of laboratory faecal calprotectin testing was noted with 27% of services reporting no access to faecal calprotectin, and a further 32% reduced access. There was also significant curtailment of IBD-specific endoscopy and elective surgery.ConclusionsIBD services in the UK have implemented several adaptive strategies in order to continue to provide safe and high-quality care for patients. National Health Service organisations will need to consider the impact of these changes in current service delivery models and staffing levels when planning exit strategies for post-pandemic IBD care. Careful planning to manage the increased workload and to maintain IBD services is essential to ensure patient safety.

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