Diagnostic Colonscopy/Flexible Sigmoidoscopy for IBS (in secondary care) You are here: Home » Procedures Of Limited Clinical Value » Diagnostic Colonscopy/Flexible Sigmoidoscopy For IBS (in Secondary Care)
Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. It can cause bouts of stomach cramps, bloating, diarrhoea and/or constipation. The symptoms vary between individuals and affect some people more severely than others. They tend to come and go in periods lasting a few days to a few months at a time, often during times of stress or after eating certain foods. You may find some of the symptoms of IBS ease after going to the toilet and opening your bowels.
IBS is thought to affect up to one in five people at some point in their life, and it usually first develops when a person is between 20 and 30 years of age. Around twice as many women are affected as men. The condition is often lifelong, although it may improve over several years.
Calprotectin is a protein biomarker which is used in the differentiation of inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS). As such in a primary care setting it assists in ruling out IBS patients, who can be managed in primary care, and facilitates appropriate referral to secondary care of patients with IBD.
Proposed revisions to the eligibility criteria
The use of calprotectin in the differentiation of inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS) is categorised as Not Routinely Funded in secondary care.
Calprotectin testing should be carried out in a primary care setting to rule out patients with IBS who can be managed in primary care and thus facilitate appropriate referral to secondary care of patients with IBD.
Calprotectin testing in secondary care
Calprotectin testing for patient’s secondary care will be funded in the following circumstances.
• If the first test shows calprotectin level >75ug/g, or if the repeat test shows levels >30ug/g the patient should be referred to secondary care for inflammatory bowel disease.
This means for patients requiring calprotectin testing in the differentiation of Inflammatory Bowel Disease (IBD) from Irritable Bowel Syndrome (IBS) in Secondary care, the CCG will only fund the treatment if an Individual Funding Request (IFR) application proves exceptional clinical need.
Requests of endoscopy to diagnose irritable bowel syndrome in secondary care will not be approved for funding unless the above process has been followed and evidenced in the funding request and referral, and therefore categorised as Not Routinely Funded.