Cited by 2,346Inflammatory Bowel DiseaseOcular Diseases and Behçet’s SyndromeAnorectal Disease Treatments and Outcomes

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

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Lamb, Christopher Andrew, Kennedy, Nicholas A, Raine, Tim, Hendy, Philip Anthony, Smith, Philip J, Limdi, Jimmy K, Hayee, Bu’Hussain, Lomer, Miranda C E +22 more·2019·Gut

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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    “Active IBD, and ileoanal pouch reconstruction reduces fertility in IBD and may also do so in people with PSC.448”

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  1. s82 Protected by copyright. on May 5, 2023 at Periodicals Department Ninewells Medical Library. http://gut.bmj.com/ Gut: first published as 10.1136/gutjnl-2019-318484 on 27 September 2019. Downloaded from s82 Lamb CA, et al. Gut 2019;68:s1-s106. doi:10.1136/gutjnl-2019-318484
  2. Sands BE, Sandborn WJ, Panaccione R, et al. LB01 Safety and efficacy of ustekinumab induction therapy in patients with moderate to severe ulcerative colitis: results from the Phase 3 UNIFI study. United Eur Gastroenterol J 2018;6:1586-97. 154 · DOI
  3. Van Assche G, D'Haens G, Noman M, et al. Randomized, double-blind comparison of 4 mg/kg versus 2 mg/kg intravenous cyclosporine in severe ulcerative colitis. Gastroenterology 2003;125:1025-31. 232
  4. s87 Lamb CA, et al. Gut 2019;68:s1-s106. doi:10.1136/gutjnl-2019-318484 Guidelines 244 · DOI
  5. Friedman AB, Brown SJ, Bampton P, et al. Randomised clinical trial: efficacy, safety and dosage of adjunctive allopurinol in azathioprine/mercaptopurine nonresponders (AAA Study). Aliment Pharmacol Ther 2018;47:1092-102. 773 · DOI
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Authors
Lamb, C. A., Kennedy, N. A., Raine, T., Hendy, P. A., Smith, P. J., Limdi, J. K., Hayee, B., 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., Johnston, P. D., Parkes, M., Sanderson, J., Terry, H., IBD guidelines eDelphi consensus group, Gaya, D. R., Iqbal, T. H., Taylor, S. A., Smith, M., Brookes, M., Hansen, R., & Hawthorne, A. B.
Affiliations
  • Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
  • University of Exeter (GB)
  • Cambridge University Hospitals NHS Foundation Trust (GB)
  • Chelsea and Westminster Hospital NHS Foundation Trust (GB)
  • Royal Liverpool and Broadgreen University Hospital NHS Trust (GB)
  • Pennine Acute Hospitals NHS Trust (GB)
  • King's College London (GB)
  • Queen Mary University of London (GB)
  • University of Leeds (GB)
  • Royal College of Surgeons in Ireland (IE)
  • Western General Hospital (GB)
  • St Mark's Hospital (GB)
  • University Hospitals Bristol NHS Foundation Trust (GB)
  • Royal Hospital for Children (GB)
  • Crohn's and Colitis UK (GB)
  • Glasgow Royal Infirmary (GB)
  • Queen Elizabeth Hospital Birmingham (GB)
  • University College London Hospitals NHS Foundation Trust (GB)
  • Brighton and Sussex Medical School (GB)
  • University of Wolverhampton (GB)
  • University Hospital of Wales (GB)
Corresponding author
Lamb, Christopher Andrew
Venue
Gut
Publisher
BMJ
Published
2019-09-27
Volume
68
Issue
Suppl 3
Pages
s1-s106
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
OpenAlex
W2976362764
Cited by
2,346
References
1,293
Citations by year
2026: 184 · 2025: 351 · 2024: 417 · 2023: 432 · 2022: 387 · 2021: 354 · 2020: 203 · 2019: 13 · 2018: 2
FWCI
144.34
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Gut (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
  • Discovery Research Portal (University of Dundee) (submittedVersion, cc-by-nc)
  • UCL Discovery (University College London) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
  • Royal Devon and Exeter Research Repository (Royal Devon and Exeter) (submittedVersion, other-oa)
  • Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton) (submittedVersion, cc-by-nc)
  • Newcastle University ePrints (Newcastle Univesity) (cc-by-nc)
Funders
  • British Dietetic Association
  • Cancer Research UK (18927, 12076)
  • National Institute for Health and Care Research (ACF-2014-14-002, CL-2014-01-005, 13/179/01, EME/13/179/01)
  • Crohn's and Colitis UK
  • Medical Research Council (MR/M00533X/1, MC_UU_00007/1)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
  • Health Sciences › Medicine › Surgery › Anorectal Disease Treatments and Outcomes
Keywords
inflammatory bowel disease, ulcerative colitis, Crohn's disease, immunosuppressive therapy, nutrition interventions, surgical management, multidisciplinary team, primary-secondary care integration, patient priorities, Delphi consensus
MeSH terms
Conservative Treatment, Systematic Reviews as Topic, Adult, Gastroenterology, United Kingdom, Humans, Societies, Medical, Inflammatory Bowel Diseases, Practice Guidelines as Topic, Disease Management, Consensus

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