Type of publication:
Conference abstract
Author(s):
*Baumert A.; *Cheetham M.
Citation:
Colorectal Disease. Conference: Association of Coloproctology of Great Britain and Ireland Annual Meeting. Harrogate United Kingdom. 27(Supplement 2) (no pagination), 2025. Date of Publication: 01 Sep 2025.
Abstract:
National guidelines for the acute management of inflammatory bowel disease (IBD) have been developed to advise clinicians on first-line investigations and optimal treatment pathways. Clinical audits are vital at a trust level for identifying gaps in these pathways and creating opportunities to implement positive change. For this project, a retrospective review was carried out on patients who underwent an emergency subtotal colectomy following admission with acute severe ulcerative colitis. Surgical patients were identified via a histopathology database and elective surgeries excluded. Key points throughout each admission were audited against national standards outlined in IBD UK and the BMJ (Lamb et al, 2019). This project specifically collected data on initial investigations (stool cultures and sigmoidoscopy), medical management (steroids and biologics) and surgical intervention (first contact with surgeons and timeframe until surgery). This audit primarily identified inconsistencies in organising investigations: 37.5% of patients did not have stool cultures recorded, and sigmoidoscopy was often delayed, occurring on average 5 days post-admission. Following the results of this audit, implementations have been suggested to create a more standardised approach for initial investigations of acute flares of ulcerative colitis. Guidelines have been made more accessible, alongside informative resources explaining why these investigations are necessary. Finally, while all patients ultimately underwent surgery within an acceptable timeframe, further education has been proposed to develop a clear pathway for appropriate surgical review. We hope that easy visualisation of the IBD treatment pathway can remind clinicians when to re-assess and escalate treatment accordingly.
DOI: 10.1111/codi.70177
Link to full-text [no password required]
