Diagnosing IBD and the use of faecal calprotectin
Top tips
Be aware that most patients are diagnosed in their teens and twenties,
IBD can develop in any age group from infants to the elderly
EXTRA INTESTINAL MANIFESTATIONS
Consider IBD in patients with unexplained fever, weight loss, anaemia, a family history of IBD
or extra-intestinal manifestations (EIM)
such as arthritis, erythema nodosum, pyoderma gangrenosum, primary sclerosing cholangitis, uveitis, iritis or episcleritis.
Up to 50% of patients with IBD experience at least one EIM, which can present before IBD is diagnosed
Diarrhoea is the most common symptom,
but this is not present in all adults
or up to 44% of children with IBD in whom delayed growth and development may occur.
Other symptoms
can include weight loss,
Abdominal pain or cramping,
Bloating,
Lethargy,
Fevers,
Night sweats,
Anaemia.
Constipation can occur in some patients.
The symptoms can overlap with many other lower gastrointestinal conditions,
including bowel cancer, coeliac disease, endometriosis and ovarian cancer, and
Beware Previous normal results
IBD can occur in patients with a previous diagnosis of Irritable Bowel Syndrome (IBS).
Faecal calprotectin testing can help differentiate between IBD and Irritable Bowel Syndrome,
facilitating appropriate referral, and is recommended by NICE
However, note that IBD can occur in patients with a previous diagnosis of Irritable Bowel Syndrome (IBS)
whose symptoms change.
Persisitent Symptoms
Inflammatory markers and faecal calprotectin can both be negative in some patients,
therefore consider referring patients with persistent symptoms.
Beware High risk cases
A quick response is essential in the case of a severe, acute flare-up,
which carries a small risk of death due to sepsis or acute kidney injury.
Top tips
Be aware that most patients are diagnosed in their teens and twenties,
IBD can develop in any age group from infants to the elderly
EXTRA INTESTINAL MANIFESTATIONS
Consider IBD in patients with unexplained fever, weight loss, anaemia, a family history of IBD
or extra-intestinal manifestations (EIM)
such as arthritis, erythema nodosum, pyoderma gangrenosum, primary sclerosing cholangitis, uveitis, iritis or episcleritis.
Up to 50% of patients with IBD experience at least one EIM, which can present before IBD is diagnosed
Diarrhoea is the most common symptom,
but this is not present in all adults
or up to 44% of children with IBD in whom delayed growth and development may occur.
Other symptoms
can include weight loss,
Abdominal pain or cramping,
Bloating,
Lethargy,
Fevers,
Night sweats,
Anaemia.
Constipation can occur in some patients.
The symptoms can overlap with many other lower gastrointestinal conditions,
including bowel cancer, coeliac disease, endometriosis and ovarian cancer, and
Beware Previous normal results
IBD can occur in patients with a previous diagnosis of Irritable Bowel Syndrome (IBS).
Faecal calprotectin testing can help differentiate between IBD and Irritable Bowel Syndrome,
facilitating appropriate referral, and is recommended by NICE
However, note that IBD can occur in patients with a previous diagnosis of Irritable Bowel Syndrome (IBS)
whose symptoms change.
Persisitent Symptoms
Inflammatory markers and faecal calprotectin can both be negative in some patients,
therefore consider referring patients with persistent symptoms.
Beware High risk cases
A quick response is essential in the case of a severe, acute flare-up,
which carries a small risk of death due to sepsis or acute kidney injury.