Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

June NICE Guidance

The National Institute of Health and Clinical Excellence has published new guidance for the month of June.

Only one of the six publications has a direct impact upon primary care, the Faecal Incontinence Guideline. The Quick Reference Guide (QRG) advises that faecal incontinence should be managed with an integrated continence service.

It is also advised that primary care clinicians should actively enquire about symptoms in high-risk groups such as: (see QRG for a complete list)

  • frail older people
  • people with loose stools or diarrhoea from any cause
  • women following childbirth (especially following third and fourth degree obstetric injury)
  • people who have had colonic resection or anal surgery
  • people who have undergone pelvic radiotherapy
  • people with perianal soreness, itching or pain
  • people with learning disabilities

In addition to this, a proactive approach to bowel management is recommended in specific groups as listed in the QRG

Action: Primary care clinicians should be aware of the availability and referral arrangements to local continence services. Active enquiry, proactive treatment and referral to continence services are likely to improve quality of life for these patients.

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