Clinical decision support

Practice guidelines and risk calculators

Third-party guidelines and prediction tools relevant to extraintestinal manifestations of IBD, each independently verified against PubMed. These are external documents and tools, linked, not reproduced, and not evidence-gated by this site.

Practice guidelines

• ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease ECCO · 2024 · PMID 37351850 · J Crohns Colitis
  THE anchor document for this page: 32 consensus statements spanning haematologic (incl. anaemia), hepatobiliary, bone/joint, skin, ocular, CNS, fatigue and endocrine EIMs. Covers every domain in scope in one place.
• ASAS-EULAR recommendations for the management of axial spondyloarthritis: 2022 update ASAS / EULAR · 2023 · PMID 36270658 · Ann Rheum Dis
  Which biologic to pick when axSpA coexists with IBD or uveitis. Recommendation 10 states TNF monoclonal antibodies are preferred for recurrent uveitis or IBD, and IL-17 inhibitors for significant psoriasis. The most directly actionable EIM drug-selection statement found.
• AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma AASLD · 2023 · PMID 36083140 · Hepatology
  How to diagnose and manage PSC and surveil for cholangiocarcinoma; introduces the 'relevant stricture' definition, advises MRCP over ERCP for diagnosis, and mandates diagnostic colonoscopy with biopsies in PSC patients without known IBD.
• EASL Clinical Practice Guidelines on sclerosing cholangitis EASL · 2022 · PMID 35738507 · J Hepatol
  European counterpart to the AASLD guidance, adds explicit graded recommendations on endoscopic management of relevant biliary strictures, pruritus, portal hypertension, IgG4-related cholangitis and paediatric disease.
• International consensus on the prevention of venous and arterial thrombotic events in patients with inflammatory bowel disease International multidisciplinary consensus (17 IBD + thrombosis experts, 12 countries) · 2021 · PMID 34453143 · Nat Rev Gastroenterol Hepatol
  Who gets thromboprophylaxis and when. 19 statements; the operative one is that thromboprophylaxis is indicated during hospitalisation of ANY cause in IBD, independent of a risk score. Free full text on PMC.
• The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Reduction of Venous Thromboembolic Disease in Colorectal Surgery ASCRS · 2023 · PMID 37318130 · Dis Colon Rectum
  The surgeon-facing VTE document: inpatient and extended pharmacologic prophylaxis, mechanical strategies, and the explicit position that VTE risk scores support an informed discussion rather than dictate prophylaxis. Updates the 2018 edition.
• British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025 BSG · 2025 · PMID 40550582 · Gut
  Whole-disease UK national reference (101 pp.) giving the IBD management context that EIM decisions sit inside. Supersedes the widely cited Lamb 2019 consensus.
• ACG Clinical Guideline Update: Ulcerative Colitis in Adults ACG · 2025 · PMID 40701556 · Am J Gastroenterol
  Current US medical-management reference for UC (54 graded recommendations, 57 key concepts), including the bone-health/osteoporosis screening posture and surgical considerations. Supersedes Rubin 2019.
• ACG Clinical Guideline: Management of Crohn's Disease in Adults ACG · 2025 · PMID 40701562 · Am J Gastroenterol
  Current US medical-management reference for Crohn's disease; drops the step-up requirement before advanced therapy, which changes which agents are available to treat a coexisting EIM. Supersedes Lichtenstein 2018.
• 2026 update of the ACR/SAA/SPARTAN recommendations for the treatment of axial spondyloarthritis in adults and children/adolescents ACR / SAA / SPARTAN · 2026
  Newest axSpA treatment guidance (released 24 Jun 2026), expanding biologic and JAK-inhibitor pathways; supersedes the 2019 ACR/SAA/SPARTAN recommendations. Free summary PDF on the ACR site.
• European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases ECCO · 2015 · PMID 25518052 · J Crohns Colitis
  The operational ferritin thresholds for diagnosing iron deficiency in IBD (<30 ng/mL in remission, <100 ng/mL in active disease) and when to use IV rather than oral iron. Still the most granular ECCO anaemia document.

Risk calculators and prediction tools

• Caprini Score for Venous Thromboembolism (2005) live calculatorexternally validatedStratifies postoperative VTE risk in surgical patients to guide prophylaxis intensity and duration; named by ASCRS 2023 as one of the two scores underpinning its risk tiers. Note: Validated broadly but performs POORLY in the exact population this page serves. In laparoscopic colorectal cancer surgery AUC was only 0.701 (optimal cut-point 10.5), and there is a well-described ceiling effect: essentially every colorectal/IBD surgical patient scores 'high risk', so the score does not discriminate WITHIN that group. Supporting studies are mostly retrospective and none is IBD-calibrated. ASCRS 2023 endorses risk scores only to enable an informed risk/benefit discussion, not to decide prophylaxis. Do not present it as an IBD tool.
• Padua Prediction Score for Risk of VTE live calculatorexternally validatedDetermines need for pharmacologic thromboprophylaxis in hospitalised MEDICAL (non-surgical) patients; adopted by the ACCP/CHEST guidelines. Note: External validation is genuinely unflattering: in an Israeli cohort of 5,117 patients VTE rates were 0.27% in the high-risk vs 0.28% in the low-risk stratum (p = 0.77), and a retrospective cohort found mandatory Padua scoring increased prophylaxis use with no reduction in VTE or mortality. The Geneva score outperformed it for identifying truly low-risk patients. Critically, a low Padua score can mislead in IBD. The 2021 international consensus (PMID 34453143) prophylaxes ALL hospitalised IBD patients regardless of score, so using Padua to withhold prophylaxis in a flaring IBD admission would contradict guideline advice.
• PREsTo (Primary Sclerosing Cholangitis Risk Estimate Tool) live calculatorexternally validatedPredicts 5-year risk of hepatic decompensation in PSC (machine-learning/gradient-boosting model). · PMID 29742811 Note: Best-discriminating PSC score in its own validation (C-statistic 0.90 in an independent Oslo cohort of ~300, vs Mayo 0.85 and MELD 0.72), but subsequent external cohorts have reported PREsTo performing WORST among available PSC scores. External validation is therefore mixed, not settled. Not validated under age 18 (the calculator says so explicitly). Predicts decompensation only; it does NOT estimate cholangiocarcinoma risk, so it cannot answer the CCA-surveillance question surgeons most often face. Mayo-hosted page carries an educational-use-only disclaimer.
• Postdischarge VTE risk calculator for inflammatory bowel disease surgery (Schlick/NSQIP) formula only, no calculatorderivation cohort onlyPredicts 30-day post-discharge VTE after colectomy or proctectomy performed for IBD; predicted probabilities ranged 0.2% to 14.3%. · PMID 33077197 Note: The most directly relevant tool for a colorectal surgical audience, and the one most likely to be over-trusted for exactly that reason, but it is DERIVATION-ONLY and has never been externally validated. Built on 18,990 patients with just 199 post-discharge VTE events, so it is at real risk of optimistic overfitting; NSQIP capture is 30-day and administratively coded. No web implementation was found, so it is not usable at the bedside without rebuilding it from the paper. Treat outputs as hypothesis-generating, not decision-grade.

Also on MDCalc

These are established instruments already hosted as free, working calculators by MDCalc. We link them rather than rebuild them. Our own decision-support tools above cover what MDCalc does not, and every link below was verified against MDCalc directly.

Guideline summaries hosted by MDCalc:

• ACG: Preventive Care in Inflammatory Bowel Disease (via MDCalc) guidelineVaccination, bone health, skin-cancer and cervical-screening recommendations for immunosuppressed IBD patients. Note: Directly relevant before starting biologics or immunomodulators, and a frequent gap in surgical clinics.