Primary care diagnostic pathway for lower GI conditions

Ana Ibarra, IBD Clinical Nurse Specialist

What is the primary care diagnostic pathway for lower GI conditions?

Delayed diagnosis for gastrointestinal (GI) conditions has a significant impact on both patients and the NHS.

Charities supporting people with lower GI symptoms have ongoing concerns, supported by evidence, that delayed diagnosis continues to impact on the people they represent.  

Whilst there are many individual pathways and guidance materials aimed at specific diseases, these often are not helpful for a patient presenting with symptoms, rather than a diagnosed condition, and it can be unhelpful for the first contact healthcare practitioner to need to refer to many separate documents.  

There is now broad agreement that to make a real impact going forward, a nationally agreed pathway for the diagnosis of people presenting with lower GI symptoms is needed. Lower GI charities working in partnership with healthcare professional organisations and patients have come together to develop this pathway in the UK. 

The pathway recently went out for consultation, receiving a huge response from professionals in primary care and secondary care, as well as people living with lower GI conditions. The consultation CLOSED on Friday 27th October 2023. Thanks to everyone for their comments.

If you have any questions about this work, or would like to get more involved with the project, get in touch at

Who developed the diagnostic pathway?


Charities and organisations

The Association of Coloproctology of Great Britain & Ireland

British Society of Gastroenterology (BSG)

British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN)

Coeliac UK

Crohn's & Colitis UK

Crohn's in Childhood Research Association (CICRA)

Guts UK

IBS Network


Steering Group

Hilary Croft - CEO of Coeliac UK

Dr Keith Lindley - Consultant and Honorary Reader in Paediatric Gastroenterology

Dr Charles Maxwell-Armstrong - Consultant Colorectal and General Surgeon

Alison Reid - CEO of IBS Network

Sarah Sleet - CEO of Crohn's & Colitis UK

Julie Thompson - Information Manager for Guts UK

Heidi Urwin - Director of Evidence and Policy for Coeliac UK

Dr Andrew Veitch - President of British Society of Gastroenterology


Task and Finish Group

Dr Sarah Alderson - GP

Dr Ian Arnott - Consultant Gastroenterologist in Scotland

Debra Attwood (co-chair) - Lived experience of Ulcerative Colitis

Pearl Avery - IBD Nurse Specialist

Mr Sas Banerjee - Consultant Colorectal Surgeon

Grace Brownfield - Lived experience of Coeliac Disease

Dr Shahida Din (co-chair) - Consultant Gastroenterologist in Scotland

Dr Barney Hawthorne - IBD Lead in Wales

Tor Maxted - Lived experience of IBS

Dr Andrew Murdock - Consultant Gastroenterologist in Northern Ireland

Dr Astor Rodrigues - Paediatric Consultant Gastroenterolgist

Dr Christian Selinger - Consultant Gastroenterologist

Dr Leena Sinha - Chair of BSG small bowel and nutrition group

Dr Neal Tucker - GP

Prof James Turvill - Consultant Gastroenterologist, York and Scarborough Teaching Hospitals NHS FT

Dr Jeremy Woodward - Member of BSG small bowel and nutrition group


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