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Practice Guideline
. 2025 Jun 23;74(Suppl 2):s1-s101.
doi: 10.1136/gutjnl-2024-334395.

British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025

Gordon W Moran  1 , Morris Gordon  2 , Vassiliki Sinopolou  2 , Shellie J Radford  3 , Ana-Maria Darie  4 , Sudheer Kumar Vuyyuru  5 , Laith Alrubaiy  6 , Naila Arebi  7 , Jonathan Blackwell  8 , Thomas D Butler  9   10 , Thean Chew  11 , Michael Colwill  12 , Rachel Cooney  13   14 , Gabriele De Marco  15   16 , Said Din  17 , Shahida Din  18 , Roger Feakins  19 , Marco Gasparetto  20   21 , Hannah Gordon  22 , Richard Hansen  23 , Klaartje B Kok  24 , Christopher Andrew Lamb  25   26 , Jimmy Limdi  27   28 , Eleanor Liu  29 , Maurice B Loughrey  30   31 , Dennis McGonagle  32 , Kamal Patel  33 , Polychronis Pavlidis  34   35 , Christian Selinger  36 , Matthew Shale  5 , Philip J Smith  37   38 , Sreedhar Subramanian  39 , Stuart A Taylor  40 , Gloria Shwe Zin Tun  41 , Ajay Mark Verma  42 , Newton A C S Wong  43 ; IBD guideline development group
Collaborators, Affiliations
Free article
Practice Guideline

British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025

Gordon W Moran et al. Gut. .
Free article

Erratum in

Abstract

In response to recent advancements in inflammatory bowel disease (IBD) management, the British Society of Gastroenterology (BSG) Clinical Services and Standards Committee (CSSC) has commissioned the BSG IBD section to update its guidelines, last revised in 2019. These updated guidelines aim to complement the IBD standards and promote the use of the national primary care diagnostic pathway for lower gastrointestinal symptoms to enhance diagnostic accuracy and timeliness. Formulated through a systematic and transparent process, this document reflects a consensus of best practices based on current evidence. The guideline, while developed primarily for the UK, is structured to support IBD management internationally. It is endorsed by the BSG executive board and CSSC without external commercial funding, with involvement primarily supported through professional roles in public institutions and the National Health Service (NHS). Methodological revisions since the prior guidelines have enhanced rigor in technical review and development, with methodology details published independently following peer review. In developing the recommendations, 89 clinical experts and stakeholders participated in an online survey, identifying primary outcomes, such as clinical and endoscopic remission, as well as adverse event metrics, all stratified by clinically relevant effect sizes. These guidelines are intended to support clinical decision-making but are not prescriptive, recognizing that individual clinical scenarios may warrant tailored approaches. Further research may inform future revisions as new evidence emerges.

Keywords: CROHN'S DISEASE; IBD; INFLAMMATORY BOWEL DISEASE; INFLIXIMAB; ULCERATIVE COLITIS.

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Conflict of interest statement

Competing interests: Gordon W Moran: Grants from Astra Zeneca, Bristol Myers Squibb, Jansen, Pfizer; Consulting fees from Alimentiv, Satisfai Health, Jansen, Pfizer; Speaker honoraria from Abbvie, Bristol Myers Squibb; Travel grants from Jansen, AbbvieMorris Gordon: No competing interestsVasiliki Sinopolou: No competing interestsShellie J Radford: No competing interestsAna Maria Darie: No competing interestsSudheer Kumar Vuyyuru: Consulting fee from Alimentativ Laith Alrubaiy: No competing interestsNailia Arebi: Takeda consulting on interpretation of publications; Personal fees for: Lilly Speaker, Pfizer speaker, Abbvie speaker, Takeda speakerJonathan Blackwell: Consulting fees from Takeda; Honoraria from Takeda, Ferring, Pfizer, Dr Falk; Travel grants Takeda, Ferring.Thomas D. Bulter: Meeting attendance from Galapagos, Celltrion Inc.Thean Chew: No competing interestsMichael Colwill: Honoraria for lectures from Dr Falk, Pfizer; Travel grant from Ferring Pharmaceuticals; Advisory board Dr Falk; Writing fees GP Pulse.Rachel Cooney: Speaker fees- Takeda, Galapagos, Falk, Abbvie; Advisory fees- BMS, Lilly, Pfizer, Abbvie; Course fees-Tillots, Celltrion, JanssenGabriele De Marco: EULAR grants; payment to the institution from Novartis; Janssen; support for attending meetings: Janssen, Novartis, UCBSaid Din: No competing interestsShahida Din: Grants from Helmsley Charitable Trust, Edinburgh and Lothians Health Foundation, Pathological Society of Great Britain and Northern Ireland, Lord Leonard and Lady Estelle Wolfson Foundation; Honoraria from Janssen, Takeda, Ferring and Abbvie; Travel support from Dr Faulk, Takeda, Lilly, Janssen, AbbvieRoger Feakins: Member of committee (pathologist) IBD UKMarco Gasparetto: Grants from Seedcorn Grant, Quadram Institute of Biotechnology (QIB), Norwich, UK, Helmsley Charitable Trust Grant, Zilbauer Group Lab 02, University of Cambridge, Jeffrey Cheah Biomedical Centre, Cambridge, UK; Honoraria from ESPGHAN – European Society of Pediatric Gastroenterology, Hepatology and Nutrition, BSPGHAN – British Society of Paediatric Gastroenterology, Hepatology and Nutrition, SIGENP - Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition; travel grants from ESPGHAN – European Society of Pediatric Gastroenterology, Hepatology and Nutritiom, BSPGHAN – British Society of Paediatric Gastroenterology, Hepatology and Nutrition, PIBD – Bioresource – NIHR UK SIP – Italian Society of Paediatrics SIP – Italian Society of Paediatrics, SIGENP - Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition, CICRA – Crohn’s in Childhood Research Association; data monitoring board for CICRA – Crohn’s in Childhood Research Association; receipt of equipment from Abbvie M14-671 Crohn’s Disease: Efficacy, Safety, and Pharmacokinetics of Upadacitinib in Paediatric Subjects with Moderately to Severely Active Crohn’s Disease. Abbvie M21-862 A Phase 2 Dose Finding Study Evaluating the Safety and Efficacy of Linaclotide in Pediatric Subjects 6 Months to Less Than 2 Years of Age with Functional Constipation (FC).Hannah Gordon: Consulting fees from Janssen, Abbvie, Galapagos, Takeda; Honoraria from Janssen, Abbvie, Ferring, Takeda, IBD scope; conference attendance fees from Janssen;Richard Hansen: Grants from Crohn’s in Childhood Research Association, The Archie Foundation; Private medicolegal feesKlaartje Bel kok: Consulting fees from abbvie, janssen; honoraria abbvie, Galapagos, Takeda, BMS, janssen ; Travel meeting costs from Galapagos, janssenChristopher Lamb: Salary support through HEI from Janssen, Takeda, Abbvie, AstraZeneca, Eli Lilly, Orion, Pfizer, Roche, Sanofi Aventis, UCB, Biogen, Genentech, Bristol Myers Squibb, GSK and Merck Sharp and Dohme (MSD), Medical Research Council, Helmsley Charitable Trust, Wellcome Trust, Crohn’s & Colitis UK, NIHR Newcastle Biomedical Research Centre, EU Innovative Medicines Initiative, Open Targets and European Bioinformatics Institute (EMBL-EBI); Consulting fees from Janssen, Bristol Myers Squibb, Eli Lilly and MSD ; Personal fees from Ferring, Takeda, Janssen, Dr Falk, Nordic Pharma; Travel grants from Tillotts Pharma UK, Janssen, British Society of Gastroenterology (BSG), International Organisation of IBD (IOIBD) and the European Crohn’s & Colitis Organisation (ECCO); Participation on data monitoring board on study funded by Jon Moulton FoundationJimmy Lindi: Consultancy and speaker fees AbbVie, Arena, Bristol Myers Squibb, BioHit, Celltrion, Eli Lilly, Ferring, Galapagos, Janssen, MSD, Pfizer, Takeda, Tillotts; Research grants: AbbVie, Galapagos, Takeda.Eleanor Liu: Speaker fees from Janssen, Galapagos; Research grant GalapagosMaurice B Loughrey: No competing interestsDennis McGonagle: No competing interestsKamal Patel: Payment or honoraria from Abbvie, Jannsen, DrFalk, Tillets, PreddictImmune, Takeda, Galapagos, Pfizer, Ferring; Participation on a Data Safety Monitoring Board or Advisory Board for Abbvie, Janssen, Galapagos; Chief Investigator Roles from Abbvie, JanssesnPolychronis Pavlidis: research grant from Galapagos; travel attendance from Janssen.Christian Selinger: Grants from AbbVie, Janssen, Consulting fees from Warner Chilcott, Dr Falk, AbbVie, Takeda, Fresenius Kabi and Janssen; Personal Honoraria from Warner Chilcott, Dr Falk, AbbVie, MSD, Pfizer and Takeda; Participation on advisory board for AbbVie, Janssen, Arena GalapagosMatthew Shale: Speaker fee and conference attendance-AbbviePhilip Smith: Personal honoraria (speaker fees) from Takeda, AbbVie, Celltrion, Janssen, Galapagos, Lilly, Dr Falk, Tillotts, Ferring, BMS, Fresenius KabiSree Subramnian: Advisory board and speaker fees from Abbvie, Takeda, Janssen, Celltrion, Dr FalkStuart Taylor: Research grant from Takeda; Consultancy fees from AstraZeneca; Personal stock holding MotilentGloria Tun: No competing interestsAjay Verma: Payment from Takeda, Abbvie, UHB, Galapogos NV. Support from Tillotts Pharma UK, Celltrion, Abbvie. Position in BSG and RCPNewton Wong: No competing interestsIBD Guideline Development group: Banner authors listed in supplementary material with Competing interests available on request.

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