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NICE updates guidance to improve endometriosis diagnosis

NICE updates guidance to improve endometriosis diagnosis

Updated guidance has today been published on the diagnosis and management of endometriosis to help health professionals detect the condition earlier.

The guidance, from the National Institute for Health and Care Excellence (NICE), makes new recommendations and updates existing ones on diagnosing the chronic long-term condition which affects at least 1.5 million people of reproductive age in the UK.

Endometriosis develops when cells normally found in the womb are present elsewhere in the body, such as the bladder and bowel. The condition can have significant physical, sexual, psychological and social impact.

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The updated guidance advises that ‘additional investigations’, such as ultrasound and referral for those with suspected or confirmed endometriosis, be carried out ‘in parallel with each other, and in conjunction with initial pharmacological treatment’.

Professor Jonathan Benger, chief medical officer (CMO) and interim director of the Centre for Guidelines at NICE, said: ‘This guideline will help healthcare professionals detect endometriosis early, to close the symptom to diagnosis and ensure more timely treatment.

‘We recognise that capacity in endometriosis clinics remains an issue, and that waiting times to be seen in secondary care can sometimes be lengthy.’

Professor Benger added that patients are not always informed when endometriosis is suspected and do not have a pathway of care explained to them.

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He explained that the new guideline should help ensure the ‘appropriate information’ is given to patient’s when required.

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The update comes after recent reports from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) and Endometriosis UK highlighted the barriers preventing endometriosis diagnosis in the UK.

According to Endometriosis UK, the average length of time to diagnosis is eight to 10 years, and as NCEPOD has pointed out, a delay in diagnosis is a significant issue as it can lead to prolonged suffering, ill health, and risks to fertility.

The guidance aims to help address these issues by:

  • Recommending specialist ultrasound as an alternative to MRI for investigating suspected endometriosis in secondary care
  • Recommending early transvaginal ultrasound in all people with suspected endometriosis, even if the pelvic or abdominal examination is normal
  • Making firmer and clearer recommendations regarding referral
  • Providing greater clarify regarding the pathway of care for those with suspected endometriosis

Women’s health minister Baroness Merron said: ‘Endometriosis can be debilitating and women with this condition have been failed for far too long.

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‘This government is determined to overhaul women’s healthcare, and these changes will help patients receive an accurate and timely diagnosis, benefitting over a million women affected.’

She pointed to the development of the government’s 10-Year Health Plan, which she said ‘will help cut waiting lists in gynaecology and get women the support they need’.

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