Stop. Go to this month's Practice feature and read the headline. A patient has found blood in the toilet; what do you think the article's about? OK, now read the article. Were you right or wrong?
This month's OTC is as much about preconceptions as it is about answers. If there's one subject in medicine that we make a snap decision about, it's gastrointestinal health. Perhaps it's because we can't see what's going on, that symptoms are often the same or similar, or maybe because we really don't want to talk about someone's bowel movements. Whatever the reason, it's all too easy to shy away from GI problems.
It's a huge medicines category. According to SymphonyIRI Group, gastrointestinal remedies make up 11 per cent of the UK's entire OTC market – a staggering £258 million. The majority of this is indigestion remedies, with laxatives and anti-diarrhoeals making up the remainder. These are products you sell every day – but do you know how they work?
In healthcare, it's all too easy to focus only on the extremes of the spectrum and little in between. These are important topics, of course. Bowel cancer's survival rate is shocking: if caught early, it has a 90 per cent survival rate after five years; caught late, and it drops to 6 per cent. This is why the government is investing so much in a TV advertising campaign encouraging people to see their GP if they have blood in their stools, and why it's so crucial you know the warning signs.
But bowel cancer is a tragic extreme. There are a whole host of other conditions you should know about to give your patients the best advice possible. So this month, we have CPD articles on heartburn and GORD, constipation and its causes, and how to tell the difference between irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), as well as three practice scenarios to challenge your skills.
Remember: you are more than capable of treating or advising on the vast majority of GI conditions. And while you should always be alert for the red flags that indicate instant referral to the pharmacist, you shouldn't be frightened to help a patient when you feel you can.