Abstract

Background: The British Society of Gastroenterology (BSG) guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease were published in 1997, and may now require revision.

Aim: An audit of UK pathologists’ use and views of the guidelines.

Methods: A one-page questionnaire was sent by e-mail to members of the Pathology Section of the BSG. The results were presented and discussed at the BSG annual meeting.

Results and conclusions: The guidelines were widely known about and regarded as useful by gastrointestinal pathologists in the UK. A system identifying the discriminant value of various histopathological features was helpful to most respondents. Suggested clinical and pathological proformas were virtually never used. In their practice, adequate clinical details were available to most respondents, although some had few opportunities for discussion of cases. Approaches to grading and other aspects of reporting differed between pathologists. Support for a revision was strong, but there were diverse reasons for this. Numerous topics to be included in a revision were suggested, including new entities (e.g. diverticular colitis, diversion proctocolitis), grading of inflammation, expression of the probability of a particular diagnosis, histological effects of treatment, and use of the term indeterminate colitis.

Conclusions: Revision or an update of the BSG guidelines is now appropriate.