Inflammatory Bowel Disease

30th April 2011 by Louise Hudman

This is a guideline which seems to be aimed predominantly at specialists. From our point of view there are a few useful bits:

  • Patient Information. It lists some useful sources of information for patients.
  • Faecal calcoprotein can be used in the assessment. (There is a good editorial on this in the BMJ. It has a sensitivity of 93% and a specificity of 96% for inflammatory bowel disease in patients with possible disease – but studies haven’t been done in primary care yet, so they advise it only in secondary care at the moment – but it may be coming our way in the future).
  • People with a flare-up should have access to specialist review within 5 days.
  • The medical treatment of IBD is covered in depth. Importantly for us, it advises on the initial management of flare-ups. The BNF summary is effectively the same for the acute management, so that is a good resource.
  • Smoking cessation in Crohn’s is the biggest single factor for reducing flares.
  • Stopping Maintenance therapy. In those with ulcerative colitis with purely distal disease, you can consider stopping maintenance therapy if they have been clear of disease for 2 years. In patients with more extensive disease, they can consider stopping maintenance therapy after 4-6 years.
  • Vitamin B12. In patients with Crohn’s who’ve had a resection < 20cm, do annual B12 tests. If there is > 20cm resected, give B12 injections (most will develop deficiency).
  • Pregnancy. Any woman wishing to become pregnant should have their disease control optimised first and should have shared care with gastro and obs.
British Gastroenterological Society www.bgs.org.uk

Read for free

Sign up to access everything.

Three-month free trial

Login

Already a member? Login to view this content.

Login

"The quality and contents of the magazine are superb. It's wonderful that GP locums now have a voice and are seen as a vital part of the medical workforce."

Dr Irene Bainbridge

See the full list of features within our NASGP membership plans

Membership