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Acute diarrhoea red flags — GPhC CRA MCQ

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HardGastrointestinal TherapeuticsAcute diarrhoea red flagsGPhC CRA

A 29-year-old returned from travel yesterday and asks for loperamide. He has passed six loose stools, one containing visible blood, has a temperature of 38.6°C and feels light-headed on standing. Which response is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Decline loperamide, arrange urgent assessment and advise oral rehydration

Visible blood and fever make loperamide unsuitable, while postural light-headedness suggests clinically important dehydration. NHS adult guidance advises urgent contact for bloody diarrhoea and supports fluid or oral-rehydration intake. The patient therefore needs urgent assessment rather than delayed routine review, and antimotility treatment should not be used to mask a potentially invasive illness.

Reference: NHS loperamide contraindications and adult diarrhoea guidance: https://www.nhs.uk/medicines/loperamide/who-can-and-cannot-take-loperamide/; https://www.nhs.uk/conditions/diarrhoea-and-vomiting/