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When patients present with GI symptoms,
and do not have any red flag symptoms,

it is important to 'test Gastro!'

Here you can learn about the clinical tools and tests available to you in the diagnosis of GI conditions, with practical guidance and real-world costs and benefits.

 

*Adapted from the Coventry and Warwickshire NHS Trust Primary Care clinical pathway for patients <45 years with symptoms of IBS for more than one month and no red flag symptoms.

 

References

 

How do I diagnose GI conditions?

Differentiating between GI conditions, the symptoms of which are very similar, can be difficult and frustrating for both patients and healthcare professionals; laboratory investigations should be used to help differentiate between GI conditions, potentially reducing the time to diagnosis.1-7

Recommended diagnostic algorithm for patients presenting with GI symptoms in primary care*

Patient <45 years with recurring GI symptoms, no red flag symptoms, and no suspicion of cancer.**

Diagnostic results should always be interpreted in the context of the clinical history. If clinical suspicion remains, despite contrary test results, consider referring the patient to secondary care.

Coeliac serology

Faecal calprotectin

Full blood count

Thyroid stimulating hormone

ESR/CRP

 

*Adapted from the National Institute for Health and Care Excellence – Faecal calprotectin guidelines, and the Coventry and Warwickshire NHS Trust Primary Care clinical pathway for patients <45 years with symptoms of ISS for more than one month and no red flag symptoms. The NICE guidelines include coeliac serology, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as tests that should be considered alongside faecal calprotectin but do not include thyroid stimulating hormone (TSH). The Coventry and Warwickshire guidelines do not include ESR and CRP but do include TSH. The tests recommended by the Coventry and Warwickshire guidelines are recommended by Dr Ramesh Arasaradnam and Dr John O'Malley; Professor Calm O'Morain also recommends these tests, however, he also includes ESR and CRP.

**Diagnostic results should always be interpreted in the context of the clinical history. If clinical suspicion remains, despite contrary test results, consider referring the patient to secondary care.

***mg/kg is equivalent to µg/g

ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein.

 

References

Related content

 

Cost benefits of faecal calprotectin testing

Faecal calprotectin testing in primary care can determine the need for an investigative scope. Use this simple cost calculator to work out how much your CCG could save.

29% AVOIDABLE
£1,242,629

£897,775

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£251,623*
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References