Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • rectal bleeding
  • diarrhoea
  • blood in stool

Other diagnostic factors

  • abdominal pain
  • arthritis and spondylitis
  • malnutrition
  • abdominal tenderness
  • fever
  • weight loss
  • constipation
  • skin rash
  • uveitis and episcleritis
  • pallor

Risk factors

  • FHx inflammatory bowel disease
  • HLA-B27
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • infection
  • not smoking or former smoker

Diagnostic investigations

1st investigations to order

  • stool studies
  • FBC
  • comprehensive metabolic panel (including LFTs)
  • ESR
  • CRP
  • plain abdominal radiograph
  • flexible sigmoidoscopy
  • colonoscopy
  • biopsies
Full details

Investigations to consider

  • serological markers: perinuclear antineutrophil cytoplasmic antibody (pANCA) and anti-Saccharomyces cerevisiae antibody (ASCA)
  • double-contrast barium enema
  • CT scan
  • radionuclide studies
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Research Fellow

St George’s Hospital

London

UK

Disclosures

AS declares that she has no competing interests.

Consultant Gastroenterologist

Department of Gastroenterology

St George’s Hospital

London

UK

Disclosures

AP is an author of a reference cited in this monograph.

Dr Anet Soubieres and Dr Andrew Poullis would like to gratefully acknowledge Dr Rhys Hewett, Dr Willem J.S. de Villiers, and Dr Houssam Mardini, the previous contributors to this monograph. RH, WJSD, and HM declare that they have no competing interests.

Peer reviewers VIEW ALL

Associate Professor of Medicine

Division of Digestive Diseases and Nutrition

University of Kentucky

Lexington

KY

Disclosures

TW declares that he has no competing interests.

Assistant Professor of Surgery

Division of Colon and Rectal Surgery

University Hospital Case Medical Center

Cleveland

OH

Disclosures

SS received a fee for educational courses on laparoscopic surgery, paid for in part by Covidien, Olympus, and Applied Medical.

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