Patients with suspected inflammatory bowel disease (IBD) could benefit from better testing protocols that would reduce the need and long waits for potentially unnecessary colonoscopies, according to a new study.
In a paper published in First-line gastroenterologyresearchers from the Birmingham NIHR Biomedical Research Center (BRC) at the University of Birmingham tested a new protocol to improve the diagnosis of IBD by combining the clinical history with multiple home stool tests.
In the two-year study involving 767 participants, patients were screened and had repeated fecal calprotectin (FCP) testing, and the research team found that the use of serial FCP testing was able to strongly predict possible IBD, as well as Crohn’s disease and ulcerative colitis.
The team noted that a second FCP test was a strong indicator of a possible need for further investigation, including a colonoscopy. although the researchers noted that only 20% of patients had two samples submitted before referral to secondary care.
Dr Peter Rimmer from the Birmingham NIHR Biomedical Research Center at the University of Birmingham and corresponding author of the study said:
“Patients presenting with symptoms associated with inflammatory bowel disease often wait a long time to receive a diagnosis and current trials are under enormous pressure.
“Using a comprehensive 13-point symptom screen and multiple FCP tests, we were able to more accurately identify patients who had IBD and other illnesses. Development of this protocol could reduce the time needed to diagnose and initiate treatment for IBD as much more than screening and testing can be done through primary care.
In its simplest form, this study may help improve referral screening for IBD patients. But as we design new care pathways, it could open up exciting new possibilities: with the increasing availability of home FCP tests, the results of these tests combined with simple symptom questionnaires could be fed into algorithms that allow patients to self-refer to secondary services care. reducing pressure on primary care. This is something we are going to investigate in a large follow-up study that we are currently starting.”
Dr Rachel Cooney, Consultant Gastroenterologist at University Hospitals Birmingham NHS Foundation Trust, researcher at NIHR Birmingham BRC and co-author of the study
Source:
Journal Reference:
Rimmer, P., et al. (2024). Optimizing emergency referral triage for suspected IBD: results from the Birmingham IBD Initial Study. First-line gastroenterology. doi.org/10.1136/flgastro-2023-102523.
