Inflammatory bowel disease

Advertising

Unit 625

August 2025

Inflammatory bowel disease

The purpose of this activity is to demonstrate how general practitioners can identify people with inflammatory bowel disease early by maintaining a high index of suspicion and ordering faecal calprotectin tests when inflammatory bowel disease symptoms are present.

The term IBD encompasses Crohn’s disease, ulcerative colitis and unclassified IBD. These are lifelong chronic diseases that usually start in childhood or early adult life, but the onset in later life is increasing, and relapse is common. IBD can limit a person’s chance of success in education and their professional and social lives and is associated with increased risk of mental health issues.

Common symptoms include abdominal pain, rectal bleeding and diarrhoea; patients may also experience fatigue, brain fog, anxiety, depression, insomnia, arthritis, fever and weight loss.

The diarrhoea can be explosive, causing incontinence, stigma and shame. Diarrhoea from gastroenteritis is a common presentation in general practice, which creates cognitive bias in the diagnosis of diarrhoea. Awareness of this potential bias is important in order to identify IBD when patients present.

Diagnostic delay for people with IBD is reported as 1–8 years. One-third experience a delay of one year; for some, it is many years more, and after diagnosis, it may take years for symptoms to be controlled.

In Australia, IBD prevalence is increasing at a faster rate than in other countries, with an estimated 180,000 Australians affected in 2025.

General practitioners are very well situated to identify people with IBD early by maintaining a high index of suspicion and ordering faecal calprotectin tests when IBD symptoms are present.

Learning outcomes

At the end of this activity, participants will be able to:
  • describe the common symptoms of IBD
  • differentiate between gastroenteritis and IBD presentations
  • propose appropriate investigations and management plans for a patient presenting with diarrhoea to reduce the risk of delayed IBD diagnosis
  • compare the benefits and harms of medications used to treat IBD
  • give examples of dietary and lifestyle interventions that affect IBD.

Case studies

Below is a list of the case studies found in this month's unit of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 

Masaki, a man aged 25 years, presents to your clinic with a two-week history of diarrhoea. He is concerned he might have ‘gastro’, as he has had it a few times before.

Joseph, aged 41 years, presents with a swollen and painful left forefoot of two weeks duration that is getting progressively worse and causing him increasing difficulty walking. He has tolerated it because he is on light duties for a shoulder injury that occurred three weeks ago, treated elsewhere.

Harriet, aged 30 years, presents with a painful perineal lump that she first noticed yesterday. She has a history of ulcerative colitis, for which she had a total colectomy and stoma formation three years ago with a rectal stump in situ. This was following several failed trials of medical therapy including mesalazine, prednisone, mercaptopurine, azathioprine and infliximab. She has no known drug allergies.

Tania, a woman aged 28 years, has recently moved to the area and has booked this appointment as she is trying to find a new general practitioner.

Tania was born in Bangladesh and migrated to Australia aged 16 years. She has a diagnosis of ulcerative colitis, which was made two years ago after presenting to her general practitioner with small-volume bloody diarrhoea and cramping abdominal pain. Her colonoscopy at the time of diagnosis showed erythema and granularity of the rectal and colonic mucosa, which was circumferential and continuous.

Sue, aged 30 years, comes in to discuss her Crohn’s disease treatment options. She wants to explore diet and lifestyle approaches, hoping these will make her feel more in control of her condition. She has a history of Crohn’s disease affecting her terminal ileum, which has caused intermittent obstructive symptoms over the past 10 years, since the symptoms first began.

CPD

This unit of check is approved for 10 hours of CPD activity (two hours per case). The 10 hours, when completed, including the online questions, comprise five hours’ Educational Activities and five hours’ Reviewing Performance.
Educational
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

Complete check online

To enroll in this check unit online: 

  1. Log into myCPD home page
  2. Select 'Browse' and search for 1242152
  3. Select the course and register

Please note: If you're not a member of the RACGP or don't have a check subscription, click here.

TOPICS

Advertising