What criteria should I use to determine when to refer a patient with ulcerative colitis for specialist care?

Criteria for referral of a patient with ulcerative colitis to specialist care include:

• Patients who are considering surgery should be referred to a specialist such as a gastroenterologist, colorectal surgeon, or an inflammatory bowel disease nurse specialist for detailed discussion of treatment options, risks, benefits, and consequences of no treatment.
• Patients with moderately to severely active ulcerative colitis who have failed or cannot tolerate conventional treatment should be referred for specialist assessment for advanced therapies including biological or other licensed medicines.
• Patients with acute severe ulcerative colitis require urgent specialist input and multidisciplinary team management.
• Patients with complex disease requiring ongoing specialist monitoring, including those needing stoma care or considering surgery, should be under specialist care.
• Referral is also indicated if there is diagnostic uncertainty or if symptoms are not controlled with standard treatment.

These criteria ensure timely specialist involvement to optimise management and improve outcomes in ulcerative colitis ¹.