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
- family history of 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
- Full blood count (FBC)
- comprehensive metabolic panel (including LFTs)
- erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- plain abdominal radiograph
- flexible sigmoidoscopy
- colonoscopy
- biopsies
Investigations to consider
- serological markers: perinuclear antineutrophil cytoplasmic antibody (pANCA) and anti-Saccharomyces cerevisiae antibody (ASCA)
- double-contrast barium enema
- CT scan
- radionuclide studies
Treatment algorithm
Contributors
Authors VIEW ALL
Research Fellow in Gastroenterology
St George's Hospital
London
UK
Disclosures
BS declares that he 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 topic.
Dr Ben Shandro and Dr Andrew Poullis would like to gratefully acknowledge Dr Anet Soubieres, Dr Rhys Hewett, Dr Willem J.S. de Villiers, and Dr Houssam Mardini, previous contributors to this topic.
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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