Table 1

Summary of red flag symptoms, signs and investigations for PIBD3

Symptoms

  • Loose stools (diarrhoea) for >14 days without another cause (such as recent travel)

  • Bloody diarrhoea or blood per rectum

  • Weight loss (Crohn’s disease only)

  • Abdominal pain>14 days without another cause (consider functional abdominal pain)

Signs

  • Perianal disease (fistulae, fissures and skin tags)

  • Frequent severe mouth ulcers (Crohn’s disease only)

  • Extra-intestinal manifestations (arthopathy, uveitis, erythema nodosum)

Investigations

  • Negative stool microscopy and culture

  • High inflammatory markers (CRP+ESR)

  • Low albumin

  • Deranged liver function

  • High platelet count

  • Low haemoglobin (especially in ulcerative colitis)

  • Positive family history of IBD (of any type)

  • CRP, C-reactive protein; ERS, erythrocyte sedimentation rate; IBD, inflammatory bowel disease.