NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)
A patient presenting with fear of gastrointestinal disease or cancer requires a structured abdominal examination and targeted baseline investigations (CBC, stool occult blood or calprotectin, and celiac serology if indicated) to exclude organic pathology. Provide clear, empathetic explanation of brain-gut axis interactions and reassurance once red flags and organic disease are ruled out. Offer referral for cognitive behavioral therapy or psychological support if health anxiety causes severe functional impairment or persistent reassurance-seeking. - Refer, with advice
Children follow the same pathway: recognise and refer. No primary-care medicine is implied.
No dose - referral pathway, no medicine given in primary care
A patient presenting with fear of gastrointestinal disease or cancer requires a structured abdominal examination and targeted baseline investigations (CBC, stool occult blood or calprotectin, and celiac serology if indicated) to exclude organic pathology. Provide clear, empathetic explanation of brain-gut axis interactions and reassurance once red flags and organic disease are ruled out. Offer referral for cognitive behavioral therapy or psychological support if health anxiety causes severe functional impairment or persistent reassurance-seeking.
- RED FLAG - Unexplained iron deficiency anemia: assess urgently and refer.
- RED FLAG - Progressive dysphagia or persistent vomiting: assess urgently and refer.
- Genuine organic symptoms - bleeding, weight loss, a mass - must still be excluded before attributing symptoms to anxiety.
- Significant functional impairment - consider referral for psychological support.
- No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.