A recent study conducted by researchers from the Birmingham NIHR Biomedical Research Centre at the University of Birmingham suggests that patients with suspected inflammatory bowel disease (IBD) could benefit from better testing protocols that would reduce the need for potentially unnecessary colonoscopies. The study, published in Frontline Gastroenterology, tested a new protocol for IBD diagnosis that combined clinical history with multiple home stool tests. In the two-year study involving 767 participants, patients were triaged and had repeated faecal calprotectin (FCP) tests, which were found to strongly predict possible IBD, Crohn’s Disease, and Ulcerative Colitis.
The researchers found that the use of serial FCP tests could be a strong indicator of the need for further investigation, including colonoscopy. However, they observed that only 20% of patients had two samples submitted prior to referral to secondary care. Dr. Peter Rimmer, corresponding author of the study, mentioned that patients experiencing symptoms associated with IBD often face long wait times for a diagnosis, and the current testing system is under immense strain. By utilizing a comprehensive 13-point symptom checker and multiple FCP tests, the researchers were able to more accurately identify patients with IBD and other diseases. The implementation of this new protocol could potentially reduce the time taken to receive a diagnosis and start treatment for IBD, as more screening and testing can be done through primary care. The sensitivity of multiple FCP tests could help flag patients who urgently need referral to secondary care.
Dr. Rachel Cooney, a Consultant Gastroenterologist at University Hospitals Birmingham NHS Foundation Trust and co-author of the study, highlighted the potential benefits of this new protocol. She mentioned that the study could help improve referral triage for IBD patients, and as new care pathways are planned, it could open up exciting possibilities. With the increasing availability of home FCP testing, the results of these tests combined with simple symptom questionnaires could feed into algorithms that allow patients to self-refer to secondary care services. This could help reduce the strain on primary care services. Dr. Cooney mentioned that a large follow-up study is currently being initiated to explore these possibilities further.
Overall, the study suggests that a new protocol combining clinical history with multiple home stool tests could improve the diagnosis and management of IBD. By using serial FCP tests, healthcare providers could more accurately identify patients who require further investigation, including colonoscopy. The implementation of this protocol could potentially reduce the time taken to diagnose and treat IBD, as more screening and testing could be done through primary care. This could help alleviate the strain on the healthcare system and allow for more efficient patient management. Further research is being conducted to explore the potential benefits of this new protocol and its impact on referral triage for IBD patients.
