Please do not use the SCI gateway referral process for acutely unwell people needing urgent assessment \u2013 there is an on-call service for GI in both WGH and RIE to provide urgent real time advice and admission if necessary. Please see the Referral Guidelines section for further information about referral for admission vs. OP referral.<\/strong><\/strong><\/p>\n\n\n\n In addition to the SCI Gateway referral process for new patients we also offer:<\/p>\n\n\n\n WGH: 0131 537 1272<\/p>\n\n\n\n SJH: 01506 523861<\/p>\n\n\n\n https:\/\/services.nhslothian.scot\/GI\/IBD<\/a><\/p>\n\n\n\n This site also includes a copy of the IBD flare card and the RCP CCUK IBD tool kit, as well links to information on the shared care agreements for azathioprine, methotrexate and mercaptopurine<\/a><\/p>\n\n\n\n J.B. & E.W. 16-05-25<\/strong><\/p>\n\n\n\n A competent clinical decision maker e.g. GP ST, GP ANP, GP<\/p>\n\n\n\n SUSPECTED NEW DIAGNOSIS OF IBD, well enough currently for OP investigation<\/strong><\/p>\n\n\n\n SUSPECTED NEW DIAGNOSIS OF IBD<\/strong>: when and how to use Faecal Calprotectin testing<\/strong><\/p>\n\n\n ESTABLISHED DIAGNOSIS OF IBD MADE ELSEWHERE<\/strong><\/p>\n\n\n\n Acutely unwell patients requiring inpatient assessment should be referred in after discussing with the on-call team NOT by SCI Gateway \u2013 see further info below.<\/strong><\/p>\n\n\n\n Please do not refer patients already known to a gastroenterologist in Lothian via the dedicated SCI Gateway IBD referral pathway. Advice about these people is available via the IBD consultant email service and the individual clinician via email. Patients are also able to get in touch directly via the IBD nurse helpline in WGH (01315371272) and St John\u2019s (01506 523861).<\/p>\n\n\n\n For patients with a possible new diagnosis of IBD who are suitable to wait for outpatient assessment<\/strong> or patients with an established diagnosis of IBD who are new to NHS Lothian please refer via SCI Gateway. Referral can be to WGH or to SJH depending on the patient\u2019s location. The SCI Gateway referral pathway is as follows:<\/p>\n\n\n\n OR<\/p>\n\n\n\n The following tests should be taken in Primary Care prior to referral (they are required for the SCI GW protocol where referrers have to indicate if the individual tests are NORMAL or ABNORMAL (drop down menu):<\/strong><\/strong><\/p>\n\n\n\n CRITERIA TO ADMIT PATIENTS WITHOUT<\/u> A KNOWN DIAGNOSIS OF IBD<\/strong><\/p>\n\n\n\n In an unwell patient with acute abdominal pain or significant bloody diarrhoea (usually over 2 weeks) and possible IBD, please consider same day referral to the gastroenterology registrar in WGH via switchboard. <\/p>\n\n\n\n Signs of toxicity include \u2265 6 bloody stools per day and one or more of following:<\/p>\n\n\n\n If toxicity present or clinical concern contact the on-call Gastroenterologist registrar and\/or admit through flow centre.<\/p>\n\n\n\n If there is peritonism (significant tenderness on abdominal examination) same day referral to the surgical team is more appropriate.<\/p>\n\n\n\n Symptoms of ulcerative colitis are dependent upon severity of disease and include bloody diarrhoea, rectal bleeding, tenesmus, urgency, faecal incontinence, and nocturnal defaecation.<\/p>\n\n\n\n Acute Severe UC<\/strong> \u2013 please consider admission via Flow Centre\/GI reg on call in WGH<\/p>\n\n\n\n 6 or more bowel movements\/24h plus<\/strong> 2 or more features of systemic upset;<\/p>\n\n\n\n Reasons for admission in people with an existing diagnosis of Crohn\u2019s include<\/p>\n\n\n\n <\/p>\n<\/div><\/div>\n\n\n\n The following tests should be taken in Primary Care prior to referral (they are required for the SCI GW protocol where referrers have to indicate if the individual tests are NORMAL or ABNORMAL (drop down menu):<\/strong><\/strong><\/p>\n\n\n\n Crohn\u2019s Disease Flare Pathway \u2013 Developed by Crohn\u2019s and Colitis UK with RCGP<\/strong><\/p>\n\n\n\n Crohn’s Flare Pathway – link to website PNG<\/a><\/p>\n\n\n\n https:\/\/apps.nhslothian.scot\/files\/sites\/2\/NHLothianGICrohns_flare_management_pathway_June_2018_FINAL.pdf<\/a><\/p>\n\n\n\n UC Flare Pathway \u2013 Developed by Crohn\u2019s and Colitis UK with RCGP<\/strong><\/p>\n\n\n\n UC Flare pathway – link to website PNG<\/a><\/p>\n\n\n\n https:\/\/apps.nhslothian.scot\/files\/sites\/2\/NHS-Lothian-GI-UC_flare_management_pathway_June_2018_Final-2.pdf<\/a> (text easier to navigate on some devices)<\/p>\n\n\n\n NHS Lothian Resources<\/strong><\/p>\n\n\n\n GI-Crohns_flare_management_pathway_June_2018_FINAL.pdf (nhslothian.scot)<\/a><\/p>\n\n\n\n https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GI-UC_flare_management_pathway_June_2018_Final-1.pdf<\/a><\/p>\n<\/div><\/div>\n\n\n\n Links to flare pathways are under Primary Care Management<\/p>\n\n\n\n NHS Lothian GI website <\/a> <\/p>\n\n\n\n RCGP Learning: Inflammatory Bowel Disease Toolkit<\/a><\/p>\n\n\n\n Crohn’s and Colitis UK Resources for HCPs<\/a> <\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":" People with inflammatory bowel disease (IBD) may be seen in WGH, RIE and St John’s. The IBD nurse helpline and biologics service for Edinburgh are based in WGH. SJH also provide a biologics service and IBD nurse helpline for patients in West Lothian. When referrals are made via the IBD SCI GW Referral Pathway for<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3955,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[206],"class_list":["post-4046","page","type-page","status-publish","hentry","category-inflammatoryboweldisease"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" Inflammatory Bowel Disease<\/a>","rttpg_excerpt":"People with inflammatory bowel disease (IBD) may be seen in WGH, RIE and St John’s. The IBD nurse helpline and biologics service for Edinburgh are based in WGH. SJH also provide a biologics service and IBD nurse helpline for patients in West Lothian. When referrals are made via the IBD SCI GW Referral Pathway for","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4046","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4046"}],"version-history":[{"count":20,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4046\/revisions"}],"predecessor-version":[{"id":24633,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4046\/revisions\/24633"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3955"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4046"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4046"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
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Who can refer<\/strong>:<\/h4>\n\n\n\n
Who to refer<\/strong>:<\/h4>\n\n\n\n
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![\"IBD](\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/IBD-FCP-Flowchart-July-2025-1024x708.png\")
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Who not to refer<\/strong>:<\/h4>\n\n\n\n
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How to refer<\/strong>:<\/h4>\n\n\n\n
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Who to refer urgently for consideration of admission (via GI on-call)<\/strong><\/h4>\n\n\n\n
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WHEN TO CONSIDER ADMISSION FOR PATIENTS WITH KNOWN UC<\/strong><\/h4>\n\n\n\n
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WHEN TO CONSIDER ADMISSION FOR PATIENTS WITH KNOWN CROHN\u2019S DISEASE<\/strong><\/h4>\n\n\n\n
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After referral<\/strong>:<\/h4>\n\n\n\n
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