# Fear of Digestive Disease

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DS90 - condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
FEAR OF DIGESTIVE DISEASE
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DS90 -
         condition scope only, no dose · Illness Anxiety Disorder - StatPearls - NCBI Bookshelf
         (NBK554399) - https://www.ncbi.nlm.nih.gov/books/NBK554399/ · No dose - referral pathway,
         no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    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
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      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.
   Caution  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.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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