Gastroenterology

Nice | Coeliac disease

This is an updated guideline on coeliac disease from NICE. They have added a few extra presentations where people should be tested, but otherwise there is little that is new. See my coeliac disease re...

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Nice | Irritable Bowel Syndrome (IBS)

This is an update to the 2008 guideline on IBS from NICE. Most of it is same; I have listed the changes. Diet Most advice is the same. However, for people with symptoms not responding to other treatme...

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Nice | Gallstone disease

This is a new guideline from NICE on gallstone disease. It doesn't say anything very surprising and doesn't change our current management, but does try to unify practice, which can currently be quite ...

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Colorectal cancer

Aimee Lettis from the GP Update team gives us short, sharp nuggets of clinical information for sessional GPs. Diagnosing colorectal cancer can be hugely challenging. Many patients come worried they ha...

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BCSH | Vitamin B12 and folate deficiency

This is a new guideline from the BCSH. It is quite a chunky guideline and it covers a lot of detail. I will give a few 'top learning points' then a more detailed summary beneath. At the end I have att...

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Pain in the bum

Aimee Lettis from the GP Update team gives us short, sharp nuggets of clinical information for sessional GPs. I’ll cover something you will be familiar with as GPs: anal fissures, as well the new test...

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Nice | Dyspepsia and GORD

This is an updated guideline from Nice on dyspepsia and GORD. It updates the guideline from 2004 and I must say I found it quite non-specific and a little confusing about certain aspects, e.g. when en...

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Nice | Ulcerative colitis

This is new guidance from Nice on ulcerative colitis. It really doesn't change anything for us. Treatment remains the same (see my PLOG on the British Gastroenterological Society guideline from 2011)....

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Crohn’s Disease

This guideline is mainly relevant for secondary care and doesn’t really change our practice. There are a few useful bits for us. General Information: Stop Smoking – encourage this as has a huge impac...

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Oral bowel preparation agents

You may have seen the recent letter from QA asking that we prescribe bowel prep for patients going to endoscopy. This guideline gives advice on how you can safely do this. Portsmouth prefers Picolax (...

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Upper gastro-intestinal bleeding

This guideline is aimed at secondary care and bleeding from peptic-ulcers or varices. Bear in mind, that this doesn’t really look at management of other causes of bleeding, like Mallory-Weiss tears an...

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Sign | Colorectal cancer

Most of this guideline won’t change our management. The following points are helpful: Prevention of colorectal cancer Patients should be advised to lower their risk by following a healthy lifestyle (...

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