7. When to Refer
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It is essential to establish how long the person has been experiencing the symptoms they describe in order to help decide whether OTC treatment should be recommended (and which one is most appropriate), or whether a referral to a GP is required for further investigation. |
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There are a number of more serious diseases that have similar symptoms to the common bowel conditions covered by this training. These include:
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Inflammatory Bowel Disease (Crohn’s Disease, Ulcerative Colitis)
Coeliac Disease
Diverticular Disease
Bowel Cancer
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Ovarian Cancer
Duodenal Ulcer
Gallstones
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Pharmacists should look out for 'red flag' symptoms which may indicate one of these more serious problems that would require further investigation by a GP.
Red Flag symptoms
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Rectal bleeding
Blood in the stool
Blood stained or white mucus in the stool
Unexplained weight loss
Unexplained fever
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Anaemia (recognised through unexplained fatigue and may be identified by checking for paleness on the palm of the hand)
Persistent abdominal pain
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Pharmacists should also be looking for:
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Recent onset of constipation that lasts longer than a few weeks
Constipation reported by a customer over the age of 55 where the reported symptoms are a new problem
Diarrhoea that shows no improvement after 48 hours, or if the condition gets worse
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Symptoms that recur frequently
Another significant medical condition that the customer may have had diagnosed
Any other symptoms that the pharmacist has concerns about
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If any of the above apply, the customer should be advised to see their GP.
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