What criteria should I use to determine when to refer a patient with Crohn's disease to a specialist?

Arrange urgent referral to secondary care (paediatric gastroenterologist for children or gastroenterologist for adults) if Crohn's disease is suspected, for confirmation of diagnosis and initiation of specialist treatment ¹.

Refer for suspected Crohn's disease if the person is systemically unwell with symptoms such as bloody diarrhoea, fever, tachycardia, or hypotension, and hospital admission is indicated ¹.

If hospital admission is not indicated, consider an urgent specialist gastroenterology review or seek specialist advice if symptoms suggest a flare-up or complication, such as recurrent disease activity or signs of disease relapse ¹.

Arrange referral if there are suspected extra-intestinal manifestations that cannot be managed in primary care, such as rheumatology, dermatology, or ophthalmology issues ¹.

In cases where diagnosis remains uncertain after primary assessment, consider referring for specialist investigation ¹.