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New draft guidance for the NHS in England and Wales proposes that women who suspect they may have endometriosis—an often painful condition affecting approximately one in ten women—could soon undergo quicker and less invasive preliminary testing through their GP. The aim is to reduce the currently lengthy diagnostic wait times, which can extend to nine years or more. The tests highlighted include a saliva-based genetic test and another that assesses electrical activity in the gut via abdominal sensors. These tools will supplement regular clinical assessments to improve detection of endometriosis, a disorder where tissue similar to the womb lining grows outside the uterus.
Ami Robertson, a 23-year-old Pilates instructor from Glasgow, shared her personal struggles with endometriosis, which began when she was 16. Despite persistent pain, she was repeatedly misdiagnosed with other conditions, such as irritable bowel syndrome, until she privately paid for diagnostic tests that confirmed her condition, eventually leading to surgery. Reflecting on her experience, Ami said, “I started to doubt myself, wondering if it was all in my head. No one should have to wait years to be believed.”
Another account comes from Sharan Uppal from Huddersfield, whose 15-year-old daughter Simran endured a similarly prolonged journey to diagnosis. Sharan recounted frequent visits to their GP and multiple emergency department admissions where they encountered delays and lack of clear ownership over Simran’s care. After privately funding the gut electrical signal test, which yielded a strong positive result, Sharan felt empowered to insist on a formal referral. “That test opened doors for us to get Simran the help she needed,” she said.
The two tests in focus are known as Endotest, the saliva assay currently involved in an NHS pilot, and Endosure, which evaluates gut electrical activity and is being studied at Worcestershire Acute NHS Hospital Trust. The gut test requires women to fast for six to eight hours beforehand and then drink water over 45 minutes during the procedure. According to the draft recommendations, family doctors will eventually be able to offer one or both tests to suitable patients, although widespread availability will take time, and usage will need oversight by clinicians experienced in endometriosis diagnosis. Importantly, these tests are not intended to replace the existing gold standard diagnosis method—laparoscopy under general anaesthetic—but are expected to accelerate the pathway to diagnosis and treatment. Emma Cox, chief executive of Endometriosis UK, noted the importance of coupling test availability with better education for GPs and practice nurses: “Availability of these new tests needs to go hand-in-hand with education of GPs and practice nurses to ensure prompt access to those that need them, and an end to pain and symptoms not being recognised.”
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