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Recent Posts by Louise Hudman

Bladder Pain Syndrome (Interstitial Cystitis)

This is a new guideline from RCOG on Bladder Pain Syndrome, which used to be called Interstitial Cystitis, among other things. As this is a new guideline and it is a common problem (affecting up to 6% of people), I will summarise the bits relevant to us. Definition This is a chronic pain syndrome and…
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Bisphosphonates, raloxifene and teriparatide for treating osteoporosis

This summary is based on 3 recent NICE guidelines: Bisphosphonates in people for primary or secondary prevention. Raloxifene for primary prevention. Basically it isn't advised. Raloxifene and teriparatide for secondary prevention. The advice hasn't changed. Previous guidance was rather complicated in that different bisphosphonates could be used at different levels of risk. This has all…
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Hearing loss and ear wax

This is a new guideline from NICE on managing hearing loss and ear wax, published in June 2018. Exciting? Well, there are a couple of good bits in here, especially given how common a problem this is. Some top tips that were new for me: Consider an urgent referral to ENT for someone of Chinese…
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Stop smoking intervention

This is a new guideline from NICE on stop smoking interventions. If you do nothing else, I would strongly encourage you to do the National Centre for Smoking Cessation and Training NCSCT e-learning module on offering very brief advice to smokers. It only takes 10 minutes and is excellent. NICE advises that we use the…
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Heavy menstrual bleeding (menorrhagia)

NICE published an update to its guideline on heavy menstrual bleeding (menorrhagia) in March 2018. There are a couple of changes: Hysteroscopy is now the first line investigation for most women who need investigating for heavy menstrual bleeding, rather than ultrasound. There is no mention of age '45' now. In the old menorrhagia guideline, being…
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Otitis Media – when to use antibiotics

This is a new guideline from NICE on when to use antibiotics for otitis media (March 2018). It doesn't change common practice, but I found some of the statistics really helpful for explaining why we prescribe in some groups and not others. There is an excellent patient leaflet explaining things too. Some background info: Most have…
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Faltering growth in children

This is a recent guideline from NICE, which gives advice on managing faltering growth in children. A lot of this is common sense, but as it is a new guideline, I will summarise the bits relevant to us. I will not deal with weight loss in the first few days, as this is generally managed…
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