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IBD Criteria

  • IBD Criteria
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IBD-REFER criteria1

Aim: to provide a risk assessment tool for early diagnosis of inflammatory bowel diseases (IBD)

Delay in diagnosing inflammatory bowel diseases (IBD) has been consistently associated with poor disease outcomes in both children and in adults. The IBD-REFER criteria were developed to assist primary care physicians to determine the risk for IBD in specific patients in order to facilitate early referral to specialists, thereby shortening the time from onset of symptoms to diagnosis. 

Ten core items are included in the IBD-REFER criteria: three major and seven minor. Validation of the IBD-REFER criteria demonstrated high sensitivity and specificity (98% and 96% in adults and 96% and 96% in children).

Note - when clinical suspicion is particularly high, even the presence of 1 minor criterion is sufficient for referral to a specialist.

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No need to refer to Gastroenterologist

The final IBD-REFER criteria.

1. Bloody stools without diarrhea not associated with a fissure or hemorrhoids also require early referral to a gastroenterologist, but in this case, not necessarily for suspected IBD.

2. Particularly in the event of nocturnal diarrhea or rectal urgency.

3. Normal serology to celiac disease should be confirmed. If height is more impaired than weight in the absence of gastrointestinal symptoms, a referral to an endocrinologist should be considered.

4. When clinical suspicion is high, the presence of even one Group 2 item is sufficient for a referral to the gastroenterologist or for determining fecal calprotectin.