Making a diagnosis of IBS or IBD can be difficult and frustrating both for patients and clinicians due to the similarities in clinical symptoms. Correct diagnosis is important, however, as management and treatment for IBS and IBD are very different. Where IBS is diagnosed, patients will receive lifestyle and dietary advice with appropriate medication to treat symptoms, whilst those patients with a suspicion of IBD will be referred to gastroenterology for specialist assessment, along with further tests and interventions, including endoscopy.
IBS is reported to have a prevalence in the general population of more than four million people, with most of these affected being between 20 and 30 years of age. However, more recently, IBS appears to be increasing with a significant prevalence in older people.
It is estimated that more than four million people suffer from IBS in the UK, with approximately 79,000 new cases being diagnosed each year. It has also been estimated that 57% of the prevalent population have consulted a healthcare professional about their symptoms in the past six months, although it is acknowledged that realistically this figure may be much higher if looked at over a 12 month period. Patients will often suffer from symptoms for a long period of time before consulting health professionals as many may find discussions embarrassing.
IBD covers a number of chronic and relapsing conditions, with two of the most common forms of IBD being ulcerative colitis and Crohn’s Disease. Both of these conditions have a profound impact on the lives of about 240,000 patients, approximately 400 patients per 100,000 population in the UK.
The cost of IBD to the NHS has been estimated at about £720 million annually, based on the prevalence and average cost of £3,000 per year per patient2 3.
Counting the Cost
The financial costs, as well as the impact that both IBS and IBD have on patients, is significant.
Calprotectin offers a diagnostic accuracy that other tests such as serological tests (ESR, CRP) are not able to provide. This is due to their inability to measure bowel inflammation specifically and these tests can be influenced by a number of other non-intestinal diseases.
A study completed in Northumberland by the NHS Technology Adoption Centre (published in 2013) showed that GP’s felt that measuring faecal Calprotectin:
- Provides additional reassurance for patients who may have anxiety or uncertainty about IBS or IBD
- Reduced number of referrals from those tests which have been clearly negative. During this project, a total of 129 patients were spared from referral to secondary care
- Identified cases for referral that may not previously have been clinically indicated
- Greater confidence in diagnosing IBS within primary care without the need for endoscopy
Implementing Calprotectin testing in your practice would mean that endoscopy waiting lists would be reduced, patients do not have to undergo unnecessary, unpleasant procedures, money will be saved and patients will be treated more appropriately and more quickly.
Calprotectin Testing in the CCG
For the implementation of Calprotectin in the CCG please download the NICE Calprotectin Costing Template below.
NICE Calprotectin Costing Template