Arrange urgent referral to secondary care (paediatric gastroenterologist for children or gastroenterologist for adults) if Crohn's disease is suspected, for confirmation of diagnosis and initiation of specialist treatment NICE CKS.
Refer for suspected Crohn's disease if the person is systemically unwell with symptoms such as bloody diarrhoea, fever, tachycardia, or hypotension, and hospital admission is indicated NICE CKS.
If hospital admission is not indicated, consider an urgent specialist gastroenterology review or seek specialist advice if symptoms suggest a flare-up or complication, such as recurrent disease activity or signs of disease relapse NICE CKS.
Arrange referral if there are suspected extra-intestinal manifestations that cannot be managed in primary care, such as rheumatology, dermatology, or ophthalmology issues NICE CKS.
In cases where diagnosis remains uncertain after primary assessment, consider referring for specialist investigation NICE CKS.