New National Guidelines on the Management of Inflammatory Bowel Disease in Adults

Dr Chris Lamb is a Consultant Gastroenterologist at the Newcastle upon Tyne Hospitals and leads research in Crohn’s and Colitis at Newcastle University. He is part of a team that have written the new British Society of Gastroenterology Inflammatory Bowel Disease guidelines that are freely available to read on the Gut journal website.

The new British Society of Gastroenterology guidelines for management of Inflammatory Bowel Disease in adults have recently been released. They are available for anyone to read and form a ‘how-to’ guide for doctors and nurses to support high quality patient care, informed by worldwide, up to date research in Crohn’s and Colitis.

The guidelines have been developed over the last 3 years by a fantastic team of 81 experts from around the UK, with really valuable help from Crohn’s & Colitis UK.

The experts represent all major professional organisations involved in IBD care including the British Society of Gastroenterology (BSG), the Association of Coloproctology of Great Britain and Ireland (ACPGBI), the Royal College of Nursing (RCN), the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), the British Dietetic Association (BDA), the British Society of Gastrointestinal and Abdominal Radiology (BSGAR) and the Primary Care Society for Gastroenterology (PCSG).

The guidelines cover drug treatments in Crohn’s and Colitis, including infliximab, adalimumab, vedolizumab, ustekinumab, tofacitinib, azathioprine, mercaptopurine and methotrexate. The document also covers assessment and management of non-drug aspects of Crohn’s and Colitis care, including pain and fatigue, psychology, diet, and how to prepare for surgery. The guidelines complement the recently published IBD Standards to describe how hospital services should be designed to best treat patients with Crohn’s and Colitis, and promote the highest standards of care. A summary of up to date research is given alongside all recommendations. The guideline is long at over 100 pages, but a table of contents, lots of electronic links around the document and to other research papers, as well as lots of useful tables, quick reference boxes and diagrams make it user-friendly and easy to find information.

Importantly patients were involved in developing the guidelines from the outset and throughout including all planning stages and writing.

Lots of patients also very kindly helped us to identify important areas where more research is needed to guide treatment decisions in the future. These include more research into cancer prevention and detection, how best to manage pain and fatigue, how to modulate gut bacteria as a treatment, and research into what surgical treatments have the least impact on sex, fertility and continence. We hope this will inform the government, research funders and the pharmaceutical industry as to the most important areas to focus research efforts and funding in the coming years.

Writing the guidelines was a huge team effort from start to finish. We are proud of the document and hope it helps patients, doctors and nurses to work in partnership and support the highest quality care in Crohn’s and Colitis in hospitals and general practices across the UK.

You can read the guidelines here.