a911d341-81cb-4e67-a96a-a45f5618c254Faecal Calprotectin Care Pathway v32016-02-22T16:12:34.0083463+00:00EMISWEBCOOK, Linda (Dr)Inclusion CriteriafalsefalseInclusion Criteriafalse9913fdca-5f08-46a0-b079-f21d2b654533falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\ul\b\f0\fs22 Inclusion Criteria\ulnone\par
\b0 Aged 18-60 with Lower Gastrointestinal Symptoms (but without 2WW cancer criteria)\b\par
}
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\viewkind4\uc1\pard\f0\fs18\par
\par
Choose the most likely diagnosis (IBS or IBD) from the options below\par
\par
}
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\viewkind4\uc1\pard\f0\fs18\par
\par
}
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\par
\par
}
falsefalseInvestigationsfalse99600155-5722-40d4-afd8-d252ebd90f14falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs18 Request the following tests (as clinically appropriate):\par
\par
*FBC *U & E, Cr *CRP \par
\par
*TFT *Calcium *Coeliac Screen \par
\par
*Stool Culture *C. difficile screen\par
\par
\b Request the required tests then return to this template when results are received.\b0\par
}
a1b61c3a-f925-45c3-8b87-dc0819615dc5falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\b\f0\fs18\par
\par
\b0\par
}
9071728a-5df0-4779-9148-eba098bb5f43falsefalseClick this link for NICE Guidance on Suspected Cancer, Recognition and Referralhttp://www.nice.org.uk/guidance/NG124daf9631-dd2a-4e86-849b-23a6417b57effalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs18\par
\par
}
falsefalsefalse94ac986e-385b-425c-8cd1-09be45c9abb7falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}{\f1\fnil\fcharset2 Symbol;}}
\viewkind4\uc1\pard\b\f0\fs18 Also consider Faecal Occult Blood (FOB) test, if available when patient is;\par
\pard{\pntext\f1\'B7\tab}{\*\pn\pnlvlblt\pnf1\pnindent0{\pntxtb\'B7}}\fi-150\li450\b0 Aged 50 and over with unexplained abdominal pain or weight loss\par
{\pntext\f1\'B7\tab}Aged under 60 with change in bowel habit or iron deficiency anaemia\par
{\pntext\f1\'B7\tab}Aged 60 and over and have anaemia even in the absence of iron deficiency\par
}
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\viewkind4\uc1\pard\f0\fs18\par
\par
}
83c68c4d-24d2-4863-9273-31516c481a26falsefalseClick here for Faecal Calprotectin Care Pathway Information for GPs http://www.scarboroughryedaleccg.nhs.uk/data/uploads/rss2/gi_and_liver_medical/faecal-calprotectin-leaflet-gp.pdfInvestigationsfalsefalseResultsfalsecce47eba-0f99-45f6-ba04-3182674ed041falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\b\f0\fs24 **Review all results / investigations upon their return**\b0\fs18\par
\par
\par
\par
}
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\viewkind4\uc1\pard\ul\b\f0\fs18 2WW referral is indicated If results show:\ulnone\b0\par
~ Anaemia (see NICE guidance NG12)\tab\tab ~ Positive Faecal Occult Blood test (see NICE guidance NG12)\par
\par
\par
\par
}
11468fed-af05-4dd5-a430-9730676eb9e2falsefalseClick here to open NICE guidance NG12http://www.nice.org.uk/guidance/NG125ba53c6b-f16a-4328-9116-f4d5e72b83a8falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
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\par
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falsefalsefalse7f196223-07fa-4f30-afd1-3d1dbecaafdffalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs18\par
\par
\par
}
32450068-afc4-4cd3-95cf-d77014ef214dfalsefalsePlease click here to open and print the Faedal Calprotectin Test patient leaflethttp://www.valeofyorkccg.nhs.uk/rss/data/uploads/gastroenterology/faecal-calprotectin-leaflet-v1.pdfc7781eb6-99be-4cd6-be03-40ec5575dd1cfalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs18\par
\par
}
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\viewkind4\uc1\pard\b\f0\fs18 If you still suspect IBS or IBD, then request a Faecal Calprotectin test.\par
\b0\par
Return to this template page when results are recieved.\par
\par
\par
\par
}
ad81d185-aebe-4a97-b856-206a89c2b278falsefalsefalsetruefalsefalsefalse3892f27b-7f64-477f-9290-2cedc9514565falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs18\par
\par
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{\colortbl ;\red34\green177\blue76;}
\viewkind4\uc1\pard\cf1\b\f0\fs36 Result <100mcg/g: Go to next page\cf0\b0\fs24\par
}
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\par
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\viewkind4\uc1\pard\cf1\b\f0\fs36 Result =>100mcg/g: \b0 Repeat Faecal Calprotectin Test\cf0\par
}
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\viewkind4\uc1\pard\f0\fs18\par
\par
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4c843263-7067-4b88-90ec-3a97f23018bffalsefalsefalsetrueFC Less than 100falsefalsefalsed60eafc7-7f1a-4adf-819b-082dc4ed9e84falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
{\colortbl ;\red255\green131\blue78;}
\viewkind4\uc1\pard\qc\cf1\b\f0\fs32 If result is =>100mcg/g\par
\ul\fs40 GO TO NEXT PAGE\cf0\par
}
falsefalsefalse6050e9f6-8f66-4a51-a11c-f08495c8da67falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
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\viewkind4\uc1\pard\qc\cf1\b\f0\fs40 If Result <100mcg/g\par
}
f11da11f-ae29-4c6f-992e-235f4c7f42a4falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\qc\ul\b\f0\fs32 LIKELY IBS\par
\ulnone\b0\fs24 (98% Certainty of IBS)\par
\fs16\par
\fs24 see NICE guidance cg61 for IBS treatment\par
\fs16\par
\fs24 or\par
\fs16\par
\fs24 consider gynaecological or urological diagnoses\par
(NICE guidance cg122)\par
}
b5f1d627-8ce0-41d3-a9a2-cdfc3b18cff4falsefalseClick here for NICE guidance cg61https://www.nice.org.uk/guidance/cg61f314b0ab-912e-47d6-9c4e-81a1c1844145falsefalseClick here for NICE guidance cg122https://www.nice.org.uk/guidance/cg122ea1339b5-6a51-4f06-b217-dcdbd8e93b7ffalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\b\f0\fs24\par
\b0\par
}
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\viewkind4\uc1\pard\qc\b\f0\fs24 If you clinically suspect IBS, then treat and review in 6 weeks\par
}
falsefalsefalse828836e5-0c24-4242-8420-9c94e6fdae6afalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\qc\b\f0\fs28 If Patient remains Symptomatic\b0\fs18\par
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\par
\par
\par
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\viewkind4\uc1\pard\ltrpar\fi720\b\f0\fs24 FC <50 AND AGED <50\tab\tab\tab\tab\tab\tab\tab FC\u8805?50 OR AGED \u8805?50\par
\pard\ltrpar\b0\fs16\par
\pard\ltrpar\fi426\fs24 consider second line IBS therapy before \tab\tab\tab\tab\tab Make routine referral to Gastroenterology\par
routine gastroenterology referral\tab\tab\tab\tab\tab\tab\tab\b (81% Certainty of IBS)\b0\par
\pard\ltrpar\fs16\par
\pard\ltrpar\fi545\li1440\fs24 or\par
\pard\ltrpar\fs16\par
\pard\ltrpar\fi720\fs24 consider gynaecological \par
and urological disease\par
\pard\ltrpar\b (99% Certainty of IBS)\par
\par
\b0\f1\fs18\par
}
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\viewkind4\uc1\pard\f0\fs24\par
\par
}
FC 100 or morefalsefalsefalse8305f5aa-23fd-4f33-9c6e-fda3b4f36fe1falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs18\par
\par
\par
\par
}
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\viewkind4\uc1\pard\qc\f0\fs44 Suspected Inflammatory Bowel Disease\par
}
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\par
\par
\par
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falsefalsefalsedbcf92fd-3cfb-453a-8b2a-5381c0128c8efalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
{\colortbl ;\red255\green126\blue10;}
\viewkind4\uc1\pard\qc\cf1\b\f0\fs40 Result between 100 - 250mcg/g\par
}
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\viewkind4\uc1\pard\f0\fs18\par
\par
\pard\qc\b\fs24 Routine\par
\b0 referral to\par
Gastroenterology\par
(12% Risk of IBD)\fs18\par
\par
\par
\par
\par
\par
\par
}
falsefalsefalse6b867718-d5e2-4478-bcd6-912a2083946afalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
{\colortbl ;\red237\green28\blue36;}
\viewkind4\uc1\pard\qc\cf1\b\f0\fs40 Result >250mcg/g\cf0\b0\fs18\par
}
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{\colortbl ;\red237\green28\blue36;}
\viewkind4\uc1\pard\qc\cf1\ul\b\f0\fs32 URGENT\cf0 \par
\ulnone\b0\fs24 referral to\par
Gastroenterology\par
\par
or\par
\par
Straight to Test\par
Colonoscopy\par
(46% Risk of IBD)\par
}
Informationfalsefalsefalsec8b85397-8ecd-49e7-8c38-b2cbd808af82falsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
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\par
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}
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\viewkind4\uc1\pard\f0\fs24 Template created by: YHCS, IT Training and Application Support Team (North Yorkshire Locality)\par
Date: 3rd February 2016\par
\par
\fs18\par
}
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\viewkind4\uc1\pard\f0\fs24 Assured by: Dr James Turvill - Consultant Gastroenterologist, York Teaching Hospital NHS Foundation Trust \par
Julie Oldroyd - Programme Manager, Yorkshire & Humber Academic Health Science Network\par
\tab \par
Date: February 2016\fs18\par
}
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{\colortbl ;\red46\green65\blue90;}
\viewkind4\uc1\pard\f0\fs18\par
\par
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\cf1\b\fs24 --------------------------------------------------------------------------------------------------------------------\par
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\cf0\b0\fs18\par
}
a50f4958-d62d-4207-9e2d-38958a8d4fecfalsefalse{\rtf1\ansi\ansicpg1252\deff0\deflang2057{\fonttbl{\f0\fnil\fcharset0 Tahoma;}}
\viewkind4\uc1\pard\f0\fs24 To suggest an amendment or if you believe the template needs reviewing in light of new clinical guidance, please e-mail your request to the Clinical Application Support Team using the address below.\par
\par
\b\i yhcs.nyyittraining@nhs.net\par
\b0\i0\par
Subject = \b Emis Web Faecal Calprotectin Care Pathway Template.\par
\par
\b0\fs18\par
\par
\'a9 2016 Yorkshire and Humber Commissioning Support - IT Training and Application Support Team (North Yorkshire Locality)\par
}