Supporting confident assessment and referral for lower GI symptoms
Evidence-based and peer-reviewed, following NICE guidance and endorsed by the RCN and RCGP.
A step by step guide for Primary Healthcare Professionals
Why the pathway was created and how it can help you in your clinical practice.
Created December 2025
Why these pathways matter
Clear, consistent clinical pathways support fast and accurate assessments of lower GI symptoms. These pathways help standardise decision-making and reduce unnecessary variation in care. Complementary patient facing resources can also help patients know what to expect.
Reduce time to diagnosis
Increase consistency in care
Support informed patient conversations
Created December 2025.
Explore the diagnostic pathways
Adult Pathway
A step-by-step guide for assessing adults with lower GI symptoms. Includes symptoms patterns and what they may indicate, red flags for suspected cancer, recommended investigations and safety netting guidance.
Paediatric Pathway
A step-by-step guide for assessing children and young people with lower GI symptoms. Includes symptoms patterns and what they may indicate, conditions to consider, recommended investigations and safety netting guidance.
How to use these resources
Put these resources into everyday practice
Developed in partnership with leading UK health organisations
Endorsed by the RCGP, RCN, BSG and BSPGHAN. Developed with national partners including Crohn’s & Colitis UK, Coeliac UK, CICRA and Guts UK.
Frequently asked questions
How should I use these pathways in practice?
These pathways are designed as quick-reference tools during consultations to support assessment, investigations and referral decisions for lower-GI symptoms.
Are these pathways aligned with NICE guidance?
Yes. NICE guidance was referred to during development to inform information and guidance. The pathways were also developed with input from The Association of Coloproctology of Great Britain & Ireland, British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN). The pathways have also been endorsed by the RCGP and RCN.
Can I share this website with patients?
Absolutely. The patients tab contains useful materials to support patients. All resources are free to download, print and hand out to paitents with persistent lower GI symptoms.
How often are these materials updated?
The pathways are reviewed every 3 years, with the next update due in 2027.
