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Lower GI (Clinical (Co-morbidities (Steatorrhoea, Hypertension,…

- - - - Montreal Classification
        E1: Proctitis
        E2: Left sided UC
        E3: Extensive UC
    - - Montreal Classification
        Age
        A1 (<16) A2 (17-40) A3 (>41)
        Location
        L1 (ileal)
        L2 (colonic)
        L3 (ileocolonic)
        L4 (isolated upper disease)
        Behaviour
        B1 (non-stricturing, non-penetrating)
        B2 (stricturing)
        B3 (penetrating)
        B4 (perianal disease modifier)
    - - Faecal calprotectin Normal: <50ug/g Moderate: >500ug/g
        Severe: >1000ug/g
      - Blood tests
      - CAT scan or MRI/MRE
      - Colonoscopy or upper endoscopy
  - - - Corticosteroids
      - Aminosalicylates
      - Immunomodulators
      - Biological therapy
    - - Resection (ileal or ileocolonic)
      - Ileostomy (stoma)
      - J Pouch (UC)
      - Total or subtotal colectomy
  - - - Skin conditions (erythema, mouth ulcers)
      - Eye inflammation
      - Liver disorders
      - Osteoporosis
      - Joint pain (arthritis)
  - - - Brain-Gut Axis
      - Gut
        
        Pain
        
        Bloating
        
        Changes in bowel habits
        
        Dyspesia
        
        N/ V/ D
    - - Biochem (CRP, albumin, Fe2+ studies, TSH)
      - Rule out Coeliac Disease
      - Colonoscopy (if >45y w chronic diarrhoea)
      - Breath test
      - Rule out other diagnoses
        
        H. Pylori infection
        
        Bacterial overgrowth
        
        Coeliac disease
        
        IBD
        
        Diverticular disease
        
        Lactose intolerance
        
        Fructose malabsorption
        
        Ovarian cancer
    - - Harness placebo
      - Low FODMAP
      - Symptomatic drug therapy
      - Psychological therapy
- - - - Weight Stable:
        EER = 100-125kJ/kg/d
        EPR = 1.2-1.5g/kg/d
        If malnourished:
        EER = 125-145kJ/kg/d
        EPR = 1.2-1.5g/kg/d