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      British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

      research-article
      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 5 , 19 , 20 , 21 , 22 , 23 , 24 , 7 , 25 , 26 , 27 , 28 , 5 , 12 , 13 , 28 , IBD guidelines eDelphi consensus group, 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 27 , 30 , 39
      (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab), (Collab)
      Gut
      BMJ Publishing Group
      Ulcerative colitis, UC, colitis, Crohn’s disease, CD, ileitis, granuloma, fistula, stricture, perianal, inflammatory bowel disease, IBD, pouch, pouchitis, guideline, classification, diagnosis, monitoring, endoscopy, endoscopic, colonoscopy, sigmoidoscopy, ultrasound, magnetic resonance, MR, computerised tomography, CT, biomarker, calprotectin, management, therapy, surgery, colectomy, adult, adolescent, suppository, enema, 5-aminosalicylate, 5-ASA, mesalazine, corticosteroid, budesonide, prednisolone, hydrocortisone, methylprednisolone, thiopurine, azathioprine, mercaptopurine, ciclosporin, cyclosporine, anti-TNF, infliximab, adalimumab, integrin, vedolizumab, ustekinumab, JAK, janus kinase inhibator, tofacitinib, therapeutic drug monitoring, anti-drug antibodies, nutrition, diet, vitamin D, anaemia, antibiotics, tuberculosis, TB, cytomegalovirus, CMV, clostridium difficile, cancer, chemoprevention, surveillance, pregnancy, fetus, breastfeeding, probiotic, antibiotic, faecal microbial transplant, vaccine, vaccination, multidisciplinary team, MDT, adherence, self-management, telephone clinic, virtual clinic, primary stress, care, shared care, fatigue, stress, psychology, psychotherapy, cognitive behavioural therapy, CBT, smoking

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          Abstract

          Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn’s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn’s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn’s disease, including patients, their families and friends.

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          Most cited references1,314

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                Author and article information

                Journal
                Gut
                Gut
                gutjnl
                gut
                Gut
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0017-5749
                1468-3288
                December 2019
                27 September 2019
                : 68
                : Suppl 3
                : s1-s106
                Affiliations
                [1 ] Newcastle University , Newcastle upon Tyne, UK
                [2 ] Newcastle Upon Tyne Hospitals NHS Foundation Trust , Newcastle Upon Tyne, UK
                [3 ] Royal Devon and Exeter NHS Foundation Trust , Exeter, UK
                [4 ] University of Exeter , Exeter, UK
                [5 ] Cambridge University Hospitals NHS FoundationTrust , Cambridge, UK
                [6 ] Chelsea and Westminster Hospital NHS Foundation Trust , London, UK
                [7 ] Imperial College London , London, UK
                [8 ] Royal Liverpool and Broadgreen University Hospitals NHS Trust , Liverpool, UK
                [9 ] The Pennine Acute Hospitals NHS Trust , Manchester, UK
                [10 ] University of Manchester , Manchester, UK
                [11 ] King’s College Hospital NHS Foundation Trust , London, UK
                [12 ] King’s College London , London, UK
                [13 ] Guy’s and St Thomas’ NHS Foundation Trust , London, UK
                [14 ] Barts Health NHS Trust , London, UK
                [15 ] Barts and the London School of Medicine and Dentistry , London, UK
                [16 ] Leeds Teaching Hospitals NHS Trust , Leeds, UK
                [17 ] University of Leeds , Leeds, UK
                [18 ] New Road Surgery , Rickmansworth, UK
                [19 ] University of Cambridge , Cambridge, UK
                [20 ] Systematic Research Ltd , Quorn, UK
                [21 ] Royal College of Surgeons in Ireland (RCSI) , Dublin, Ireland
                [22 ] ECD Solutions , Bridgetown, Barbados
                [23 ] University of Edinburgh , Edinburgh, UK
                [24 ] Western General Hospital , Edinburgh, UK
                [25 ] St Mark’s Hospital , Harrow, UK
                [26 ] University Hospitals Bristol NHS Foundation Trust , Bristol, UK
                [27 ] Royal Hospital for Children Glasgow , Glasgow, UK
                [28 ] Crohn’s and Colitis UK , Hatfield, UK
                [29 ] Glasgow Royal Infirmary , Glasgow, UK
                [30 ] University of Glasgow , Glasgow, UK
                [31 ] Queen Elizabeth Hospital Birmingham NHSFoundation Trust , Birmingham, UK
                [32 ] University of Birmingham , Birmingham, UK
                [33 ] University College London , London, UK
                [34 ] University College London Hospitals NHS Foundation Trust , London, UK
                [35 ] Brighton and Sussex University Hospitals NHS Trust , Brighton, UK
                [36 ] Brighton and Sussex Medical School , Brighton, UK
                [37 ] Royal Wolverhampton NHS Trust , Wolverhampton, UK
                [38 ] University of Wolverhampton , Wolverhampton, UK
                [39 ] University Hospital of Wales , Cardiff, UK
                Author notes
                [Correspondence to ] Dr Christopher Andrew Lamb, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK; christopher.lamb@ 123456newcastle.ac.uk and Dr A Barney Hawthorne, Department of Gastroenterology, University Hospital of Wales, Cardiff, CF14 4XW; barney.hawthorne@ 123456wales.nhs.uk
                Author information
                https://orcid.org/0000-0002-7271-4956
                https://orcid.org/0000-0003-4368-1961
                https://orcid.org/0000-0002-5855-9873
                https://orcid.org/0000-0002-1377-7172
                https://orcid.org/0000-0003-1568-3978
                https://orcid.org/0000-0002-1039-6251
                https://orcid.org/0000-0003-1670-8815
                https://orcid.org/0000-0002-9369-8115
                https://orcid.org/0000-0002-5285-7714
                https://orcid.org/0000-0003-2022-5859
                https://orcid.org/0000-0002-0785-1815
                https://orcid.org/0000-0001-6904-1255
                https://orcid.org/0000-0002-9112-5698
                https://orcid.org/0000-0001-7137-5799
                https://orcid.org/0000-0002-3033-5851
                https://orcid.org/0000-0003-1117-1588
                https://orcid.org/0000-0001-6462-5091
                https://orcid.org/0000-0001-8643-8617
                https://orcid.org/0000-0002-4192-6526
                https://orcid.org/0000-0002-6467-0631
                https://orcid.org/0000-0002-0556-6965
                https://orcid.org/0000-0002-8920-5752
                https://orcid.org/0000-0003-1942-7568
                https://orcid.org/0000-0002-6681-9882
                https://orcid.org/0000-0002-6765-8806
                https://orcid.org/0000-0002-7442-6093
                https://orcid.org/0000-0002-8782-0292
                https://orcid.org/0000-0002-3944-6646
                https://orcid.org/0000-0002-8768-4550
                Article
                gutjnl-2019-318484
                10.1136/gutjnl-2019-318484
                6872448
                31562236
                69e65d85-12af-4f2a-931e-a7c5c75ac84c
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 10 February 2019
                : 10 June 2019
                : 10 June 2019
                Categories
                Guidelines
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                2312
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                Gastroenterology & Hepatology
                ulcerative colitis, uc,colitis,crohn’s disease, cd,ileitis,granuloma,fistula,stricture,perianal,inflammatory bowel disease, ibd,pouch,pouchitis,guideline,classification,diagnosis,monitoring,endoscopy,endoscopic,colonoscopy,sigmoidoscopy,ultrasound,magnetic resonance, mr,computerised tomography, ct,biomarker,calprotectin,management,therapy,surgery,colectomy,adult,adolescent,suppository,enema,5-aminosalicylate,5-asa,mesalazine,corticosteroid,budesonide,prednisolone,hydrocortisone,methylprednisolone,thiopurine,azathioprine,mercaptopurine,ciclosporin,cyclosporine,anti-tnf,infliximab,adalimumab,integrin,vedolizumab,ustekinumab,jak,janus kinase inhibator,tofacitinib,therapeutic drug monitoring,anti-drug antibodies,nutrition,diet,vitamin d,anaemia,antibiotics,tuberculosis, tb,cytomegalovirus,cmv,clostridium difficile,cancer,chemoprevention,surveillance,pregnancy,fetus,breastfeeding,probiotic,antibiotic,faecal microbial transplant,vaccine,vaccination,multidisciplinary team, mdt,adherence,self-management,telephone clinic,virtual clinic,primary stress,care,shared care,fatigue,stress,psychology,psychotherapy,cognitive behavioural therapy, cbt,smoking

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