Our current review emphasizes the importance of monitoring nutritional status and its significance during the management of patients with inflammatory bowel disease. We aimed to summarize the available score systems and therapeutic principles based on the most recent recommendations that can be easily used in clinical practice.

Perianal fistulas are well known complications of Crohn’s disease (CD), and can be associated with significant morbidity and reduced quality of life. Different classifications describing perianal fistulas mostly are based on their relationship to the external and internal anal sphincters. Optimal management of perianal fistulizing CD requires a collaboration between gastroenterologists and surgeons. Current medical management based on antibiotics, biologic agents and immunomodulators. Despite the introduction of biologic medical therapies, the best fistula healing rates reported with combined medical and surgical approaches are approximately 50%. Newer cell based therapy raising new hopes for better outcomes.

This brief review focuses on the gastrointestinal features of the COVID-19, pandemic. Presentation of the illness in the digestive system provides novel opportunities for clinical, diagnostic and therapeutic activi­ties. Early recognition of the disease through its gastrointestinal symptoms may have significant future epidemiologic importance.

Besides the pulmonary disease caused by the new type of coronavirus, digestive symptoms can often occur. Olfactory and gustatory disturbances are quite frequent and can precede pulmonary symptoms. The frequency and severity of diarrhea are variable and can be caused by the infection itself but also by the given medication. Nausea and vomiting also vary in frequency and severity. Gastrointestinal bleeding is rare. Elevations of liver enzymes are common, as a consequence of the inflammatory state, drug-induced liver injury or pre-existent liver disease. Angiotensin-converting enzyme 2 receptors are widely distributed along the digestive tract, where the coupling of the virus is facilitated by serine proteases. Once having entered the epithelial cells, the virus follows its life cycle, damaging the infected cells. Endoscopic examinations are strictly restricted to emergencies and must be performed under the bidirectional protection of both patients and staff. The diagnostic approach, management and follow-up of liver diseases – including transplantation – should also be conducted with preventive restrictions. Dozens of drugs are under investigation: their efficacy for COVID-19 is not yet established but the digestive side effects are well known. There is no innovative compound against the virus. It is presumed that probiotics may have preventive and protective effects, but their routine administration is not recommended.