This is a broad question, as the workup varies considerably depending on the presenting complaint. Here's a structured overview of the investigations commonly considered before or alongside a paediatric GI referral, organised by clinical presentation.
<keypoints>- Baseline bloods for most referrals: FBC, CRP, ESR, albumin, iron studies, coeliac serology (on gluten-containing diet), LFTs
- Faecal calprotectin is the key non-invasive stool marker to differentiate IBD from functional GI disorders
- Stool MCS and parasites should be sent to exclude infectious causes before referral
- Growth charting (weight, height, BMI) is essential; faltering growth is a red flag for organic disease
- Imaging and endoscopy are typically deferred to the paediatric GI specialist
Baseline Investigations (Applicable to Most Referrals)
Bloods
- FBC with differential: looking for anaemia, thrombocytosis, leucocytosis
- Inflammatory markers: CRP and ESR
- Albumin (hypoalbuminaemia is common in Crohn's disease)
- Iron studies: ferritin, transferrin saturation
- Coeliac serology: tissue transglutaminase (tTG) IgA + total IgA (on a gluten-containing diet)
- LFTs including transaminases and GGT