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Diverticulitis: pockets of knowledge

Diverticulitis occurs when small pockets in the wall of the large bowel become inflamed, usually without a specific identifiable... View Article

March 2023

Coeliac disease: investigation and management

Coeliac disease affects approximately 1 in 100 adults. However, it is often unrecognised as symptoms can be vague and non-specific... View Article

August 2022

H. pylori: who to test and how to treat

Helicobacter pylori infection increases the risk of peptic ulcer disease and gastric cancer due to long-term inflammation and... View Article

July 2022

Plant-based diets: are they healthy for a child?

With the increasing popularity of plant-based diets, there is much discussion about whether these are healthy and nutritious for... View Article

December 2021

Diagnosing and managing lactose intolerance

Primary lactase deficiency, the main cause of lactose intolerance, is estimated to affect 8% of people in New Zealand, with substantially... View Article

December 2021

Follow-up and surveillance for people after treatment for bowel cancer

Bowel cancer is a leading cause of cancer mortality in New Zealand, second only to lung cancer. Follow-up and surveillance of... View Article

August 2021

Surveillance for people with polyps or inflammatory bowel disease

Guidance for following up people who have had polyps identified on colonoscopy and people with inflammatory bowel disease, who... View Article

August 2021

Inflammatory bowel disease – a focus on Crohn’s disease and ulcerative colitis

Crohn’s disease and ulcerative colitis are the principal forms of chronic inflammatory bowel disease (IBD). Currently over 20,000... View Article

February 2021

Consider blue-green algal blooms this summer: Identifying and managing suspected cyanotoxin poisoning in primary care

Cyanobacteria, also referred to as blue-green algae, are micro-organisms that live in freshwater and marine environments. Under... View Article

November 2020

Referral of patients with features suggestive of bowel cancer: Ministry of Health guidance

Bowel cancer is one of the most common causes of cancer death in New Zealand. Approximately one-quarter of diagnoses are made... View Article

February 2020

Managing constipation in older people

Constipation is common in older people due to factors such as multimorbidity, polypharmacy, frailty, dehydration, a lack of exercise... View Article

February 2019

Stopping proton pump inhibitors in older people

Over one-third of people aged 65 years and older in New Zealand were dispensed a proton pump inhibitor (PPI) in the last year.... View Article

January 2019

Hereditary diffuse gastric cancer: an overview for primary care

Hereditary diffuse gastric cancer makes up around 1% of stomach cancer diagnoses, however, Māori in New Zealand are disproportionately... View Article

September 2018

The Year in Review - What did we learn in 2014?

In 2014 we published over 60 medical education articles in Best Practice Journal, spanning more than 450 pages. Context is crucial... View Article

February 2015

Proton pump inhibitors: When is enough, enough?

Proton pump inhibitors (PPIs) are one of the most widely used medicines in New Zealand; in 2013 omeprazole was the third most... View Article

June 2014

Biliary colic and complications from gallstones

Gallstones are common among the general population, but because they rarely cause symptoms many people are unaware of their presence.... View Article

June 2014

Managing gastro-oesophageal reflux disease (GORD) in adults: an update

Heartburn, the cardinal symptom of gastro-oesophageal reflux disease, is experienced by 15 – 20% of adults at least once a week.... View Article

June 2014

Rural infections series: Rural round up

In the final instalment of the rural series we present a round-up of infections that may be seen in patients living in, working... View Article

May 2014

The changing face of Helicobacter pylori testing

A more recent article has been published on this topic: click here There is ongoing debate in the literature about which is... View Article

May 2014

Rural infections series: Investigating and managing people with diarrhoea

Campylobacter, Salmonella, Cryptosporidium and Giardia cause diarrhoeal illnesses in thousands of people annually in New Zealand.... View Article

February 2014

Irritable bowel syndrome in adults: Not just a gut feeling

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterised by recurrent bouts of abdominal discomfort... View Article

February 2014

The use of omeprazole in infants is still high

Omeprazole is not approved for use in infants (children aged under one year). Although omeprazole is effective at reducing gastric... View Article

December 2013

Non-steroidal anti-inflammatory drugs (NSAIDs): Making safer treatment choices

Non-steroidal anti-inflammatory drugs (NSAIDs) are successfully used to treat a wide range of painful conditions. However, NSAIDs... View Article

October 2013

A quick guide to managing anal fissures

Anal fissures are small tears in the epithelium of the anus that can be intensely painful. Most anal fissures are caused due to... View Article

April 2013

Hypomagnesaemia with proton pump inhibitors

IN DECEMBER, 2012 MEDSAFE published a warning on the risk of hypomagnesaemia for people taking any proton pump inhibitor (PPI).... View Article

April 2013

Laboratory investigation of infectious diarrhoea

This report discussus how testing behaviour in New Zealand has changed over the past five years and includes feedback on the testing... View Article

October 2012

Appropriate use of the faecal occult blood test for colorectal cancer

What is a faecal occult blood test? When should a faecal occult blood test be requested? How should the results of a faecal... View Article

June 2012

Surveillance of people at increased risk of colorectal cancer

The incidence of colorectal cancer in New Zealand is high by international standards. New Zealand females have one of the highest... View Article

May 2012

Nausea and vomiting in pregnancy

Nausea and vomiting are very common symptoms of early pregnancy and usually resolve by 16–20 weeks gestation (most commonly by... View Article

November 2011

Irritable infants reflux and GORD

In New Zealand, empiric treatment with omeprazole for infant irritability and reflux is increasing, despite the fact that it is... View Article

November 2011

Dietary advice for people with coeliac disease

People with a confirmed diagnosis of coeliac disease must adhere to a life-long gluten-free diet. When first diagnosed, nutritional... View Article

May 2011

Prescription Kitchen videos

Links to video files of the TV show broadcast on Sky channel 950, Thursday May 5th View Article

May 2011

Managing dyspepsia and heartburn in general practice - an update

Dyspepsia is not a diagnosis but rather a description of symptoms that may indicate disease of the upper gastrointestinal tract.... View Article

February 2011

Bowel cancer screening in New Zealand

Progress to date on a national screening programme for bowel cancer View Article

July 2010

Investigating the Gut: Helicobacter pylori

A more recent article has been published on this topic: click here The choice of test for initial testing for H. pylori, is... View Article

March 2010

Investigating the Gut: Coeliac disease

Tissue transglutaminase antibodies are the most useful preliminary step for testing people with a clinical picture suggestive... View Article

March 2010

Investigating the Gut: Inflammatory bowel disease - the role of faecal calprotectin

Clinical assessment of intestinal inflammation can be problematic. Faecal calprotectin can be useful in differentiating between... View Article

March 2010

Investigating the Gut: Lactose intolerance

The role of laboratory tests in diagnosing lactose intolerance in primary care is limited. In most cases the diagnosis can be... View Article

March 2010

Investigating the Gut: Pernicious anaemia

There are a number of causes of low vitamin B12 levels with pernicious anaemia being among the most important to identify. Parietal... View Article

March 2010

Investigating the Gut: Steatorrhoea

In the past, the faecal fat test was sometimes used to aid the diagnosis of steatorrhoea. This practice is no longer recommended.... View Article

March 2010

Testing for enteric pathogens: Follow up report

This web version is a sample only, all data below the national level has been omitted. View Article

March 2010

Assessment and management of infectious gastroenteritis

Every year around 200,000 New Zealanders acquire a food associated illness. Gastrointestinal diseases account for the majority... View Article

December 2009

TNF inhibitors - an update

Tumour necrosis factor (TNF) inhibitors are used in the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis,... View Article

November 2009

Practice tips: PPIs and Paraffin

All about PPIs, Fire hazard with paraffin View Article

September 2009

Crohn’s disease and ulcerative colitis

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases. These conditions are usually managed in... View Article

September 2008

Dietary advice for people with coeliac disease

When people are newly diagnosed with coeliac disease, their nutritional status is often compromised, and they may require repletion... View Article

August 2008

Infant formula

Although breastfeeding is the best option for an infant, cows’ milk based formula is recommended if breast feeding does... View Article

August 2008

Strategies to improve nutrition in elderly people

Many older people suffer from the “anorexia of ageing”. The best option for treating malnutrition is to enhance normal... View Article

August 2008

The investigation of coeliac disease: A follow up

Dr Richard Steele provides some clarification on the issue of which tests are most appropriate for investigating coeliac disease... View Article

April 2008

The Importance of Being Regular

Assessing the risk and benefit of alternative therapy for GI conditions View Article

October 2007

Coeliac Disease

Coeliac disease is a common but often unrecognised disorder, affecting about 1 in 100 people. Symptoms of coeliac disease are... View Article

October 2007


Most cases of constipation in adults are mild and intermittent and respond to lifestyle changes such as increasing fibre in the... View Article

October 2007

Irritable bowel syndrome

Irritable bowel syndrome affects approximately 1 in 10 people, mainly women between the ages of 20 and 50 years. Treatment is... View Article

October 2007

Lactose intolerance

Lactose intolerance affects many adults and children. It is either genetically determined or experienced transiently as a result... View Article

October 2007

Dear Dave

Can Proton Pump Inhibitors cause vitamin B12 deficiency? View Article

May 2007

Winter Ills

Bronchiolitis | Cough in children | Fever in children | Acute gastroenteritis in children | Acute asthma in children aged 1-15... View Article

May 2007

10 minute audit: omeprazole

This audit is designed to identify people in your practice on omeprazole View Article

April 2007

Managing heartburn undifferentiated dyspepsia and functional dyspepsia in general practice

Heartburn, undifferentiated dyspepsia and functional dyspepsia are common and management requires an individually tailored combination... View Article

April 2007

Testing for Coeliac disease

Anti-endomysial (EMA) antibody or anti-tissue transglutaminase (TTG) are the best initial tests for detecting coeliac disease,... View Article

March 2007