关键词： 5-ASA 5-aminosalicylate CMV Crohn’s disease, CD JAK Ulcerative colitis, UC adalimumab adherence adolescent adult anaemia anti-TNF anti-drug antibodies antibiotic antibiotics azathioprine biomarker breastfeeding budesonide calprotectin cancer care chemoprevention ciclosporin classification clostridium difficile cognitive behavioural therapy, CBT colectomy colitis colonoscopy computerised tomography, CT corticosteroid cyclosporine cytomegalovirus diagnosis diet endoscopic endoscopy enema faecal microbial transplant fatigue fetus fistula granuloma guideline hydrocortisone ileitis inflammatory bowel disease, IBD infliximab integrin janus kinase inhibator magnetic resonance, MR management mercaptopurine mesalazine methylprednisolone monitoring multidisciplinary team, MDT nutrition perianal pouch pouchitis prednisolone pregnancy primary stress probiotic psychology psychotherapy self-management shared care sigmoidoscopy smoking stress stricture suppository surgery surveillance telephone clinic therapeutic drug monitoring therapy thiopurine tofacitinib tuberculosis, TB ultrasound ustekinumab vaccination vaccine vedolizumab virtual clinic vitamin D

Mesh ： Adult Consensus Conservative Treatment / standards Disease Management Gastroenterology Humans Inflammatory Bowel Diseases / therapy Practice Guidelines as Topic / standards Societies, Medical United Kingdom

来  源：   DOI：10.1136/gutjnl-2019-318484   PDF(Pubmed)

Abstract：
Ulcerative colitis and Crohn\'s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age was developed by Stakeholders representing UK physicians (British Society of Gastroenterology), surgeons (Association of Coloproctology of Great Britain and Ireland), specialist nurses (Royal College of Nursing), paediatricians (British Society of Paediatric Gastroenterology, Hepatology and Nutrition), dietitians (British Dietetic Association), radiologists (British Society of Gastrointestinal and Abdominal Radiology), general practitioners (Primary Care Society for Gastroenterology) and patients (Crohn\'s and Colitis UK). A systematic review of 88 247 publications and a Delphi consensus process involving 81 multidisciplinary clinicians and patients was undertaken to develop 168 evidence- and expert opinion-based recommendations for pharmacological, non-pharmacological and surgical interventions, as well as optimal service delivery in the management of both ulcerative colitis and Crohn\'s disease. Comprehensive up-to-date guidance is provided regarding indications for, initiation and monitoring of immunosuppressive therapies, nutrition interventions, pre-, peri- and postoperative management, as well as structure and function of the multidisciplinary team and integration between primary and secondary care. Twenty research priorities to inform future clinical management are presented, alongside objective measurement of priority importance, determined by 2379 electronic survey responses from individuals living with ulcerative colitis and Crohn\'s disease, including patients, their families and friends.
摘要：
溃疡性结肠炎和克罗恩病是炎症性肠病的主要形式。两者都代表胃肠道的慢性炎症，随着时间的推移，患者之间和个体内部的炎症和症状负担表现出异质性。最佳管理依赖于临床医生与患者合作理解和定制基于证据的干预措施。此16岁以上成人炎症性肠病管理指南由代表英国医生（英国胃肠病学会）的利益相关者制定，外科医生（大不列颠和爱尔兰结肠病学协会），专科护士（皇家护理学院），儿科医生(英国儿科胃肠病学会，肝病学和营养学），营养师（英国饮食协会），放射科医师（英国胃肠道和腹部放射学学会），全科医生（胃肠病学初级保健协会）和患者（克罗恩病和结肠炎英国）。对88247份出版物进行了系统审查，并进行了涉及81名多学科临床医生和患者的Delphi共识程序，以制定168项基于证据和专家意见的药理学建议。非药物和手术干预，以及在溃疡性结肠炎和克罗恩病的管理中提供最佳服务。提供了关于适应症的全面最新指导，开始和监测免疫抑制疗法，营养干预,pre,围手术期及术后管理，以及多学科团队的结构和功能以及初级和二级保健之间的整合。提出了20项研究重点，以告知未来的临床管理，在客观衡量优先重要性的同时，由2379名来自溃疡性结肠炎和克罗恩病患者的电子调查回复确定，包括患者,他们的家人和朋友。
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