Document type
Clinical pathways
East and North Hertfordshire
Output type
Clinical Pathways
Inflammatory Bowel Disease (IBD) Suspected

Inflammatory Bowel Disease (IBD)

Please see attached pathway for guidance on the diagnosis of Inflammatory Bowel Disease in primary care (including the use of faecal calprotectin as a diagnostic aid) and when to refer on to secondary care.
The following patients should be referred to emergency care:
- Systemically unwell
- Features of intestinal obstruction
- Suspected acute severe colitis
Red Flags for Lower GI Cancer:
- Rectal bleeding plus any one or more of abdominal pain, change in bowel habit, weight loss, or iron deficiency anaemia OR
- Abdominal, rectal or anal mass or unexplained anal ulceration
See FIT Pathway for suspected Lower GI Cancer and refer as 2WW.
Refer for urgent specialist assessment in patients with symptoms of IBD with:
- positive (>250) faecal calprotectin OR
- Family history of IBD OR extraintestinal manifestations of IBD AND 2 indeterminate (100-250) faecal calprotectin results 1 month apart
For referral to ENHT, please use the IBD Proforma - appropriate patients referred on this proforma will be seen within 4 weeks in an IBD clinic.