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

Christopher Andrew Lamb; Nicholas A. Kennedy; Tim Raine; Philip Anthony Hendy; Philip J. Smith; Jimmy K. Limdi; Bu'Hussain Hayee; Miranda C.E. Lomer; Gareth C. Parkes; Christian Selinger; Kevin J. Barrett; R. Justin Davies; Cathy Bennett; Stuart Gittens; Malcolm G. Dunlop; Omar Faiz; Aileen Fraser; Vikki Garrick; Paul D. Johnston; Miles Parkes; Jeremy Sanderson; Helen Terry; Daniel R. Gaya; Tariq H. Iqbal; Stuart A. Taylor; Melissa Smith; Matthew Brookes; Richard Hansen; A. Barney Hawthorne

doi:10.1136/gutjnl-2019-318484

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

, Christopher Andrew Lamb, Nicholas A. Kennedy, Tim Raine, Philip Anthony Hendy, Philip J. Smith, Jimmy K. Limdi, Bu'Hussain Hayee, Miranda C.E. Lomer, Gareth C. Parkes, Christian Selinger, Kevin J. Barrett, R. Justin Davies, Cathy Bennett, Stuart Gittens, Malcolm G. Dunlop, Omar Faiz, Aileen Fraser, Vikki Garrick, Paul D. JohnstonMiles Parkes, Jeremy Sanderson, Helen Terry, Daniel R. Gaya, Tariq H. Iqbal, Stuart A. Taylor, Melissa Smith, Matthew Brookes, Richard Hansen, A. Barney Hawthorne

Molecular and Clinical Medicine

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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.

Original language	English
Pages (from-to)	s1-s106
Number of pages	107
Journal	Gut
Volume	68
Early online date	27 Sept 2019
DOIs	https://doi.org/10.1136/gutjnl-2019-318484
Publication status	Published - 7 Nov 2019

Keywords

5-aminosalicylate
5-ASA
adalimumab
adherence
adolescent
adult
anaemia
anti-drug antibodies
anti-TNF
antibiotic
antibiotics
azathioprine
biomarker
breastfeeding
budesonide
calprotectin
cancer
care
chemoprevention
ciclosporin
classification
clostridium difficile
CMV
cognitive behavioural therapy, CBT
colectomy
colitis
colonoscopy
computerised tomography, CT
corticosteroid
Crohn’s disease, CD
cyclosporine
cytomegalovirus
diagnosis
diet
endoscopic
endoscopy
enema
faecal microbial transplant
fatigue
fetus
fistula
granuloma
guideline
hydrocortisone
ileitis
inflammatory bowel disease, IBD
infliximab
integrin
JAK
janus kinase inhibator
magnetic resonance, MR
management
mercaptopurine
mesalazine
methylprednisolone
monitoring
multidisciplinary team, MDT
nutrition
perianal
pouch
pouchitis
prednisolone
pregnancy
primary stress
probiotic
psychology
psychotherapy
self-management
shared care
sigmoidoscopy
smoking
stress
stricture
suppository
surgery
surveillance
telephone clinic
therapeutic drug monitoring
therapy
thiopurine
tofacitinib
tuberculosis, TB
Ulcerative colitis, UC
ultrasound
ustekinumab
vaccination
vaccine
vedolizumab
virtual clinic
vitamin D

ASJC Scopus subject areas

Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/gutjnl-2019-318484Licence: CC BY-NC

Final Published VersionFinal published version, 7.36 MBLicence: CC BY-NC

Cite this

, Lamb, C. A., Kennedy, N. A., Raine, T., Hendy, P. A., Smith, P. J., Limdi, J. K., Hayee, BH., Lomer, M. C. E., Parkes, G. C., Selinger, C., Barrett, K. J., Davies, R. J., Bennett, C., Gittens, S., Dunlop, M. G., Faiz, O., Fraser, A., Garrick, V., ... Hawthorne, A. B. (2019). British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut, 68, s1-s106. https://doi.org/10.1136/gutjnl-2019-318484

@article{5dba3d86c0094490aae0f00092f2085c,

title = "British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults",

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.",

keywords = "5-aminosalicylate, 5-ASA, adalimumab, adherence, adolescent, adult, anaemia, anti-drug antibodies, anti-TNF, antibiotic, antibiotics, azathioprine, biomarker, breastfeeding, budesonide, calprotectin, cancer, care, chemoprevention, ciclosporin, classification, clostridium difficile, CMV, cognitive behavioural therapy, CBT, colectomy, colitis, colonoscopy, computerised tomography, CT, corticosteroid, Crohn{\textquoteright}s disease, CD, cyclosporine, cytomegalovirus, diagnosis, diet, endoscopic, endoscopy, enema, faecal microbial transplant, fatigue, fetus, fistula, granuloma, guideline, hydrocortisone, ileitis, inflammatory bowel disease, IBD, infliximab, integrin, JAK, janus kinase inhibator, magnetic resonance, MR, management, mercaptopurine, mesalazine, methylprednisolone, monitoring, multidisciplinary team, MDT, nutrition, perianal, pouch, pouchitis, prednisolone, pregnancy, primary stress, probiotic, psychology, psychotherapy, self-management, shared care, sigmoidoscopy, smoking, stress, stricture, suppository, surgery, surveillance, telephone clinic, therapeutic drug monitoring, therapy, thiopurine, tofacitinib, tuberculosis, TB, Ulcerative colitis, UC, ultrasound, ustekinumab, vaccination, vaccine, vedolizumab, virtual clinic, vitamin D",

author = "Lamb, {Christopher Andrew} and Kennedy, {Nicholas A.} and Tim Raine and Hendy, {Philip Anthony} and Smith, {Philip J.} and Limdi, {Jimmy K.} and Bu'Hussain Hayee and Lomer, {Miranda C.E.} and Parkes, {Gareth C.} and Christian Selinger and Barrett, {Kevin J.} and Davies, {R. Justin} and Cathy Bennett and Stuart Gittens and Dunlop, {Malcolm G.} and Omar Faiz and Aileen Fraser and Vikki Garrick and Johnston, {Paul D.} and Miles Parkes and Jeremy Sanderson and Helen Terry and Gaya, {Daniel R.} and Iqbal, {Tariq H.} and Taylor, {Stuart A.} and Melissa Smith and Matthew Brookes and Richard Hansen and Hawthorne, {A. Barney}",

note = "Publisher Copyright: {\textcopyright} 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.",

year = "2019",

month = nov,

day = "7",

doi = "10.1136/gutjnl-2019-318484",

language = "English",

volume = "68",

pages = "s1--s106",

journal = "Gut",

issn = "0017-5749",

publisher = "BMJ Publishing Group",

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Lamb, CA, Kennedy, NA, Raine, T, Hendy, PA, Smith, PJ, Limdi, JK, Hayee, BH, Lomer, MCE, Parkes, GC, Selinger, C, Barrett, KJ, Davies, RJ, Bennett, C, Gittens, S, Dunlop, MG, Faiz, O, Fraser, A, Garrick, V, Johnston, PD, Parkes, M, Sanderson, J, Terry, H, Gaya, DR, Iqbal, TH, Taylor, SA, Smith, M, Brookes, M & Hansen, R & Hawthorne, AB 2019, 'British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults', Gut, vol. 68, pp. s1-s106. https://doi.org/10.1136/gutjnl-2019-318484

TY - JOUR

T1 - British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults

AU - Lamb, Christopher Andrew

AU - Kennedy, Nicholas A.

AU - Raine, Tim

AU - Hendy, Philip Anthony

AU - Smith, Philip J.

AU - Limdi, Jimmy K.

AU - Hayee, Bu'Hussain

AU - Lomer, Miranda C.E.

AU - Parkes, Gareth C.

AU - Selinger, Christian

AU - Barrett, Kevin J.

AU - Davies, R. Justin

AU - Bennett, Cathy

AU - Gittens, Stuart

AU - Dunlop, Malcolm G.

AU - Faiz, Omar

AU - Fraser, Aileen

AU - Garrick, Vikki

AU - Johnston, Paul D.

AU - Parkes, Miles

AU - Sanderson, Jeremy

AU - Terry, Helen

AU - Gaya, Daniel R.

AU - Iqbal, Tariq H.

AU - Taylor, Stuart A.

AU - Smith, Melissa

AU - Brookes, Matthew

AU - Hansen, Richard

AU - Hawthorne, A. Barney

N1 - Publisher Copyright: © 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.

PY - 2019/11/7

Y1 - 2019/11/7

N2 - 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.

AB - 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.

KW - 5-aminosalicylate

KW - 5-ASA

KW - adalimumab

KW - adherence

KW - adolescent

KW - adult

KW - anaemia

KW - anti-drug antibodies

KW - anti-TNF

KW - antibiotic

KW - antibiotics

KW - azathioprine

KW - biomarker

KW - breastfeeding

KW - budesonide

KW - calprotectin

KW - cancer

KW - care

KW - chemoprevention

KW - ciclosporin

KW - classification

KW - clostridium difficile

KW - CMV

KW - cognitive behavioural therapy, CBT

KW - colectomy

KW - colitis

KW - colonoscopy

KW - computerised tomography, CT

KW - corticosteroid

KW - Crohn’s disease, CD

KW - cyclosporine

KW - cytomegalovirus

KW - diagnosis

KW - diet

KW - endoscopic

KW - endoscopy

KW - enema

KW - faecal microbial transplant

KW - fatigue

KW - fetus

KW - fistula

KW - granuloma

KW - guideline

KW - hydrocortisone

KW - ileitis

KW - inflammatory bowel disease, IBD

KW - infliximab

KW - integrin

KW - JAK

KW - janus kinase inhibator

KW - magnetic resonance, MR

KW - management

KW - mercaptopurine

KW - mesalazine

KW - methylprednisolone

KW - monitoring

KW - multidisciplinary team, MDT

KW - nutrition

KW - perianal

KW - pouch

KW - pouchitis

KW - prednisolone

KW - pregnancy

KW - primary stress

KW - probiotic

KW - psychology

KW - psychotherapy

KW - self-management

KW - shared care

KW - sigmoidoscopy

KW - smoking

KW - stress

KW - stricture

KW - suppository

KW - surgery

KW - surveillance

KW - telephone clinic

KW - therapeutic drug monitoring

KW - therapy

KW - thiopurine

KW - tofacitinib

KW - tuberculosis, TB

KW - Ulcerative colitis, UC

KW - ultrasound

KW - ustekinumab

KW - vaccination

KW - vaccine

KW - vedolizumab

KW - virtual clinic

KW - vitamin D

UR - http://www.scopus.com/inward/record.url?scp=85070056729&partnerID=8YFLogxK

U2 - 10.1136/gutjnl-2019-318484

DO - 10.1136/gutjnl-2019-318484

M3 - Review article

C2 - 31562236

SN - 0017-5749

VL - 68

SP - s1-s106

JO - Gut

JF - Gut

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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