Chapter 1: Clinical Overview
Why referral matters
Most diarrhoea settles on its own, but some customers can become dehydrated quickly or may have another condition that needs medical assessment.
Age and dehydration are two of the most important referral factors.
Refer to the pharmacist if:
there is blood or mucus in the stool
there is severe tummy pain or pain in the back passage
there is a fever
vomiting is severe or stops the customer keeping fluids down
there is any sign of dehydration
diarrhoea has lasted 14 days or more
the customer is losing weight without trying
diarrhoea alternates with constipation
Age-related referral
Refer if:
the customer is a baby under 6 months
a baby under 1 year has had diarrhoea for more than 24 hours
a child under 12 has had diarrhoea for 2 days or more
an older customer has had diarrhoea for 2 days or more
Also refer if:
the customer is pregnant
they have heart failure, diabetes or another long-term condition
they have a weakened immune system, are on chemotherapy or take long-term steroids
they have recently travelled to a tropical or subtropical country
they have recently taken antibiotics
a medicine or laxative overuse may be causing the diarrhoea
stools are pale, oily or difficult to flush
Refer before discussing a medicine to stop diarrhoea if:
the customer is under 12
the customer is pregnant or breastfeeding
they are buying for someone else and cannot answer your questions
you are not confident that the request is within your role
Blood in the stool
Blood in the stool during diarrhoea is outside the scope of community pharmacy.
Do not supply anything and do not reassure the customer. Take them to the pharmacist.
Vomiting and fluids