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Acute diarrhoea red flags — GPhC CRA MCQ

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ModerateGastro-intestinal TherapeuticsAcute diarrhoea red flagsGPhC CRA

A 44-year-old man asks for loperamide for diarrhoea after returning from travel. He has passed blood and mucus, has a temperature of 38.5°C and has cramping abdominal pain. He is drinking fluids and has no long-term conditions. What is the most appropriate action?

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Correct answer: C — Do not supply loperamide and advise urgent clinical assessment

Blood, mucus, fever and abdominal pain suggest invasive infection or inflammatory pathology, where antimotility medicines may be inappropriate. The patient needs clinical assessment and hydration advice. Co-codamol may worsen gut motility and mask symptoms. Stopping fluids increases dehydration risk.

Reference: BNF Loperamide; NICE CKS Diarrhoea