monitor the height and body weight of children and young people with ulcerative colitis against expected values on centile charts (and/or z scores) at the following intervals according to disease activity:
every 3-6 months:
if they have an inflammatory exacerbation and are approaching or undergoing puberty or
if there is chronic active disease or
if they are being treated with systemic corticosteroids every 6 months during pubertal growth if the disease is inactive every 12 months if none of the criteria above are met
monitor pubertal development in young people with ulcerative colitis using the principles of Tanner staging, by asking screening questions and/or carrying out a formal examination
consider referral to a secondary care paediatrician for pubertal assessment and investigation of the underlying cause if a young person with ulcerative colitis:
has slow pubertal progress or
has not developed pubertal features appropriate for their age
monitoring of growth and pubertal development:
can be done in a range of locations (for example, at routine appointments, acute admissions or urgent appointments in primary care, community services or secondary care)
should be carried out by appropriately trained healthcare professionals as part of the overall clinical assessment (including disease activity) to help inform the need for timely investigation, referral and/or interventions, particularly during pubertal growth
if the young person prefers self-assessment for monitoring pubertal development, this should be facilitated where possible and they should be instructed on how to do this
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