Presentations
- Abdominal pain
- Abnormal imaging (colon, fistula, thickened small bowel)
- Anaemia
- Diarrhoea
- Draining fistula
- Fever
- Malabsorption
- Nausea/Vomiting
- Raised inflammatory markers:
- blood
- faecal (faecal calprotectin)
- Rectal bleeding
- Weight loss
Conditions
- Crohn’s disease
- Ulcerative colitis
- Indeterminate colitis
PCH
Conditions
- Very early onset (VEO) inflammatory bowel disease
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Conditions that mimic IBD (e.g. Behçet disease, chronic granulomatous disease)
- Lower gastrointestinal colitis (see KG4)
- Microscopic colitis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Causes
- Awareness of the role of the colonic milieu (environment, genetics, microbiome)
- Dietary considerations, effects, and implications
- Environmental aspects (e.g. smoking)
- Genetic factors associated with IBD
Clinical/natural history
- Predictors of severity of disease, including age of presentation, smoking status, family history (i.e. genetic predisposition to IBD), nutritional status
- Recognise potential complications of disease and its management, and initiate preventative strategies (e.g., osteoporosis)
Therapeutics
- Genetics of thiopurine S-methyltransferase (TPMT), including interpretation of thiopurines metabolites
- Understanding of small molecules and biologic therapy
Clinical assessment tools
- Monitoring disease activity
- Monitoring response to therapy toxicities and strategies and options to alter therapy
Investigations
- Cancer screening
- Endoscopic evaluation
- Faecal microscopy and culture (e.g. Clostridium difficile toxin test, faecal calprotectin)
- Intestinal ultrasound
- Plan and arrange appropriate investigations, including capsule endoscopy, colonoscopy, gastroscopy, MRE, MRI rectum
- Radiological evaluation of disease and activity
Procedures
- Endoscopic intervention, including indications and options
- Know indications for and when to involve a colorectal surgeon
- Understanding of and indications for different surgical options
- Conception counselling and pregnancy management
- Genetic counselling
- Management of chronic immunosuppression (e.g. bone health, skin checks, vaccination)
- Nutritional management
- Psychosocial and psychosexual impacts
- Recognising and management of complications
- Role of multidisciplinary assessment and care
- Transition from paediatric to adult care
