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Inflammatory bowel disease refers to chronic diseases that cause inflammation of the intestines. Ulcerative colitis and Crohn’s disease are the commonest types presenting in children, however, the terms IBD-U and microscopic colitis may also be used following confirmation of diagnosis.
Symptoms can include:
Faecal calprotectin can also be useful. However, it does not “diagnose” IBD in children and is used less often than in adults as part of primary assessment. Therefore faecal calprotectin should not be requested from primary care as a screening investigation in children under the age of 16 for isolated abdominal pain unless requested by local gastro lead or tertiary centre. If requested to be sent from primary care, please indicate which secondary or tertiary centre paediatrician has suggested, and include full history in clinical details.
Active IBD may also be associated with abnormality of liver enzymes.
Do not start steroids in first presentation of suspected paediatric IBD.
If IBD suspected via regular paediatric referral pathway refer via eRs to the Paediatric Gastroenterology Service - marked 'Urgent suspected IBD'. Secretary phone 0300 422 8494 if need to discuss
If child is acutely unwell or gastroenterology lead not available and you need to discuss please refer directly via paediatrician on call (bleep 1133)
All children and young people have their universal health care provided in primary care, Management of their IBD is shared with local secondary care (paediatric gastroenterology with an interest),led by tertiary paediatric gastroenterology.
Shared care drug monitoring including regular blood tests. Usual “routine” blood tests carried out are FBC, Plasma Viscosity (or ESR), LFT, CRP. Blood test monitoring will be indicated in shared care information from tertiary centre, or in letter from local lead.
Shared care management of flare ups. Family or young person likely to make direct contact with secondary or tertiary care for advice regarding deteriorating symptoms. Phone call or letter by fax to surgery will indicate any change in treatment, Thank you for prescribing as needed.
Transition. The concept of transition will be discussed with child and family from soon after diagnosis and at regular intervals thereafter. Transition clinic appointment usually takes place post 16 and post GCSEs.
Immunisations. Annual flu jab (inactivated) recommended for patients on immunosuppression. Please refer to local and national guidelines for all immunisation advice in patients on immunosuppression.