John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. Microbiome, probiotics, brain-gut, diet, motility, IBD, MedEd 🇬🇷

Oct 24, 2021, 18 tweets

Preventing complications of #IBD, with the amazing @MLongMD at @AmCollegeGastro #ACG2021

#GITwitter

The best treatment is prevention!

Case

Infections in #IBD

Herpes zoster (shingles) is ⬆️ in #IBD

⚠️Tofacitinib significantly ⬆️ risk, especially high dose

Influenza ⬆️ in #IBD, especially with steroid use.

🏥Flu complications are also ⬆️ in IBD.

Pneumonia is ⬆️ in #IBD, especially with steroid use.

😷#IBD does not ⬆️ #COVID19 complication risk
😷biologics do not ⬆️ risk of severe #COVID outcomes
😷there is ⬆️ risk with steroids and combo therapy

#VaxxedNMasked

💉 Vaccines in #IBD

💉Remember HPV, herpes zoster, and #COVID19

💉#COVID19 vaccines are effective and safe in #IBD, and do NOT cause IBD flares

Encourage boosters!

Summary of vaccines in #IBD 💉

Cancer in #IBD.

Since the introduction of biologics, the risk of extraintestinal cancers has ↔️, and the risk of #GI cancers has ⬇️

Preventing cervical dysplasia in #IBD

#womenshealth

Skin cancer is ⬆️ in #IBD, especially with thiopurine use (non-melanoma)

Melanoma is ⬆️in #IBD, but the absolute risk is very low.

CD > UC

Anti-TNFs ⬆️ risk

💎s from @MLongMD on preventing complications in #IBD

Prevention is 🔑

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