There is often a delay in diagnosing inflammatory bowel disease in primary care as it is frequently mistaken for irritable bowel syndrome. Stool samples should be requested for anyone suspected of having IBD and faecal calprotectin can also help to rule out IBS.

Red flag symptoms such as rectal bleeding, anaemia, abnormal biochemical markers (e.g. CRP) and unintentional weight loss should be triggers for referral to secondary care.

All patients with IBD should be provided with clear information to support self-management and early intervention in the case of a flare.

Community pharmacy teams can support IBD patients by encouraging them to stop smoking, ensuring they have nutritional deficiencies corrected, that therapy-related side-effects (e.g. cancer, blood dyscrasias and infections) are being monitored and that they are aware of what signs to look out for, especially if on immunosuppressants.

In addition, community pharmacists should provide appropriate guidance regarding vaccinations, prevention of osteoporosis, and sun protection if on thiopurines/biologics.