Clinical Resources & Tools

Clinical care pathways (CCP) are structured, standardized, evidence-based multidisciplinary management algorithms, identifying an appropriate sequence of clinical interventions and timeframes for IBD patients.

Sixteen (16) IBD CCPs were developed by IBD Unit Specialists at the University of Alberta and University of Calgary. IBD CCPs are supported by systematic reviews of published evidence and are comprised of protocols, algorthims and checklists that help to harmonize clinical and administrative aspects and ensure continuity of IBD care in outpatient settings.

All IBD CCPs can be found at ibdclinic.ca/tools-for-hcps, including the IBD flare pathway for optimal management of an IBD flare and corticosteroid pathway for the initiation and maintenance of corticosteroids to minimize the risk of repeated corticosteroids.

Clinical Practice Guidelines

Managing luminal Crohn’s Disease 
Panaccione, R., Steinhart, A. H., Bressler, B., Khanna, R., Marshall, J. K., Targownik, L., ... & Bernstein, C. N. (2019). Canadian Association of Gastroenterology clinical practice guideline for the management of luminal Crohn’s disease. Journal of the Canadian Association of Gastroenterology, 2(3), e1-e34. https://doi.org/10.1093/jcag/gwz019

Management of Perianal Crohn’s Disease (2019)
Steinhart, A. H., Panaccione, R., Targownik, L., Bressler, B., Khanna, R., Marshall, J. K., ... & Williams, C. (2019). Clinical practice guideline for the medical management of perianal fistulizing Crohn’s disease: the Toronto consensus. Inflammatory bowel diseases, 25(1), 1-13. https://doi.org/10.1093/ibd/izy247

Management of nonhospitalized UC (2015) 
Bressler, B., Marshall, J. K., Bernstein, C. N., Bitton, A., Jones, J., Leontiadis, G. I., ... & Williams, C. (2015). Clinical practice guidelines for the medical management of nonhospitalized ulcerative colitis: the Toronto consensus. Gastroenterology, 148(5), 1035-1058. https://doi.org/10.1053/j.gastro.2015.03.001

Management of IBS 
Moayyedi, P., Andrews, C. N., MacQueen, G., Korownyk, C., Marsiglio, M., Graff, L., ... & Vanner, S. (2019). Canadian Association of Gastroenterology clinical practice guideline for the management of irritable bowel syndrome (IBS). Journal of the Canadian Association of Gastroenterology, 2(1), 6-29. https://doi.org/10.1093/jcag/gwy071 

Management of bile acid diarrhea
Sadowski, D. C., Camilleri, M., Chey, W. D., Leontiadis, G. I., Marshall, J. K., Shaffer, E. A., ... & Walters, J. R. (2020). Canadian Association of Gastroenterology clinical practice guideline on the management of bile acid diarrhea. Journal of the Canadian Association of Gastroenterology, 3(1), e10-e27. https://doi.org/10.1093/jcag/gwz038

Vaccinations for IBD patients 
Benchimol, E. I., Tse, F., Carroll, M. W., deBruyn, J. C., McNeil, S. A., Pham-Huy, A., ... & Jones, J. L. (2021). Canadian Association of Gastroenterology clinical practice guideline for immunizations in patients with inflammatory bowel disease (IBD)—part 1: Live vaccines. Journal of the Canadian Association of Gastroenterology, 4(4), e59-e71. https://doi.org/10.1093/jcag/gwab015

Jones, J. L., Tse, F., Carroll, M. W., deBruyn, J. C., McNeil, S. A., Pham-Huy, A., ... & Benchimol, E. I. (2021). Canadian Association of Gastroenterology clinical practice guideline for immunizations in patients with inflammatory bowel disease (IBD)—Part 2: Inactivated vaccines. Journal of the Canadian Association of Gastroenterology, 4(4), e72-e91. https://doi.org/10.1093/jcag/gwab016

Papp, K. A., Haraoui, B., Kumar, D., Marshall, J. K., Bissonnette, R., Bitton, A., ... & Wade, J. (2019). Vaccination guidelines for patients with immune-mediated disorders on immunosuppressive therapies—executive summary. Journal of the Canadian Association of Gastroenterology, 2(4), 149-152. https://doi.org/10.1093/jcag/gwy069

Consensus Statements

Transition of IBD patients from pediatric to adult care  
Fu, N., Bollegala, N., Jacobson, K., Kroeker, K. I., Frost, K., Afif, W., ... & Benchimol, E. I. (2022). Canadian consensus statements on the transition of adolescents and young adults with Inflammatory Bowel Disease from pediatric to adult care: A collaborative initiative between the Canadian IBD Transition Network and Crohn’s and Colitis Canada. Journal of the Canadian Association of Gastroenterology, 5(3), 105-115. https://doi.org/10.1093/jcag/gwab050

Management of IBD during pregnancy
Nguyen, G. C., Seow, C. H., Maxwell, C., Huang, V., Leung, Y., Jones, J., ... & Paterson, W. (2016). The Toronto consensus statements for the management of inflammatory bowel disease in pregnancy. Gastroenterology, 150(3), 734-757. https://doi.org/10.1053/j.gastro.2015.12.003

European nursing roles in IBD (N-ECCO)
Kemp, K., Dibley, L., Chauhan, U., Greveson, K., Jäghult, S., Ashton, K., ... & Bager, P. (2018). Second N-ECCO consensus statements on the European nursing roles in caring for patients with Crohn’s disease or ulcerative colitis. Journal of Crohn's and Colitis, 12(7), 760-776. https://doi.org/10.1093/ecco-jcc/jjy020

Canadian IBD Nursing (CANIBD) is a community of practice for nurses that are working in the field of IBD who help to ensure people of all ages living with IBD in Canada receive high-quality clinical nursing care within a multidisciplinary team.
 
CANIBD has developed several resources for IBD nurses and healthcare providers, such as biologic therapy teaching tools for ulcerative colitis and Crohn's disease, as well as vaccination guidelines. Access these resources and more here.

Learn more about CANIBD. 

The Canadian Associaton of Gastroenterology (CAG) offers a number of resources to support high quality digestive health clinical care for Canadians, such as:

• CAG Quality Improvement Programs - An overview of several CAG programs, including improving endoscopic skills, evaluating endoscopic service as well as physician practice comparison to national results for self-evaluative purposes.
• Canada-Global Rating Scale (C-GRS) - The C-GRS examines 12 items related to Clinical Quality and the Quality of the Patient Experience. 
• Inflammatory Bowel Disease- Global Rating Scale (IBD-GRS) - The Global Rating Scale (GRS) is a web-based self-assessment quality improvement tool used to identify gaps in health care, change the focus to patient-centred care and standardize care.

For provider information about virtual health care, please visit your province's webpage: 

• Alberta Health Services - Virtual Health
• Saskatchewan Health Authority - Virtual Care
• Manitoba - MBTelehealth
• Ontario Health - Ontario Telemedicine Network   
• Réseau québécois de la télésanté
• Nova Scotia Health - Virtual Care

Habashi, P., Bouchard, B. & Nguyen, G.C., On Behalf of the Promoting Access and Care through Centres of Excellence (PACE) Network. (2019) Transforming Access to Specialist Care for Inflammatory Bowel Disease: The PACE Telemedicine Program, Journal of the Canadian Association of Gastroenterology, Volume 2, Issue 4, Dec  2019, 186–194, doi.org/10.1093/jcag/gwy046

Nursing Textbooks
Readers can use these books to enhance understanding of all apsects of IBD, including diagnostics, treatment and other aspects of IBD

• IBD Nursing (2010). Edited by Marion O’Connor.  NACSCORP, INC; 1st edition 
• ​IBD Nursing Manual (2019). Edited by Andreas Sturm and Lydia White. Springer Cham, 1at Edition. https://link.springer.com/book/10.1007/978-3-319-75022-4

Abdominal Examinations

• Physical exam skills (videos)
• Practical guide to clinical medicine - Exam of the abdomen

Crohn's and Colitis Canada also provides several resources to support patients with IBD. Visit the Information & Resource Hub.