Table 1.
Definitions of Red Flags in Inflammatory Bowel Disease
| Red Flag | Method of Ascertainment | Definition of Positive Finding |
|---|---|---|
| Alarm symptoms | ||
| Involuntary weight loss | History | Involuntary decrease in weight of >1 kg |
| Rectal blood loss | History | Rectal blood loss with defecation without constipation according to Rome III criteria |
| Family history of IBD | History | Affected first-degree relative(s) |
| Growth failure | History and physical examination | Target height range > −1 standard deviation score |
| Extraintestinal symptoms | Physical examination | Eyes (episcleritis, scleritis, uveitis), skin (erythema nodosum, pyoderma gangrenosum, psoriasis), mouth ulcers, finger clubbing, arthritis |
| Perianal lesions | Physical examination | Skin tags, hemorrhoids, fissures, fistulas, abscesses |
| Blood markers | ||
| Hemoglobin | Local laboratory | Age 4–12 y: <7.1 mmol/L; age 12–18 y: boys <8.1 mmol/L, girls <7.4 mmol/L25 |
| C-reactive protein | Local laboratory | >10 mg/L26 |
| Erythrocyte sedimentation rate | Local laboratory | >20 mm/h26 |
| Platelet count | Local laboratory | >450 × 109/L27 |
IBD = inflammatory bowel disease.