Here is the thing almost nobody tells you before a gut appointment: with IBS, your description is the diagnostic test. There is no blood test that says "yes, this is IBS". Guidelines now ask doctors to make a positive diagnosis from your symptom pattern plus a short list of checks, rather than ruling out every other condition first (Lacy 2021). Which means the sentences you say in the first minute do more work than anything else in the room.
That is unfair, because you are tired, possibly embarrassed, and have been rehearsing this in the car. But it is also good news, because it is learnable. The criteria your doctor is checking against have a specific shape, and once you know the shape you can answer it directly instead of hoping the right details fall out.
This guide is not about being braver or less embarrassed. It is about translation: turning what your gut actually does into the handful of facts that determine your diagnosis, your tests, and whether anyone takes another look.
The short answer: say the pain, the stool and the start date first
If you only get one clear run at it, say this: where the abdominal pain or discomfort is, what happens to it when you open your bowels, what your stools look like and how often, and when all of this began. Then anything that looks like a red flag. Diet, stress, and what you have already tried can all wait.
That order is not arbitrary. It matches how the diagnostic criteria are built. IBS is defined by recurrent abdominal pain or discomfort that is linked to defecation, to a change in how often you go, or to a change in stool form (Corsetti 2026). NICE frames it the same way: a diagnosis should be considered only if you have abdominal pain or discomfort that is either relieved by opening your bowels or associated with altered bowel frequency or stool form, alongside supporting features such as bloating or distension, symptoms made worse by eating, and passage of mucus (NICE CG61).
So when you open with "my stomach has been awful for years and nothing helps", you have said something true and important that unfortunately maps onto none of the boxes. When you open with "I get cramping low down on the left, it eases after I go, and my stools have been type 6 most mornings since March", you have handed over three quarters of a diagnosis in one breath.
Why your words matter more than they used to
IBS used to be a diagnosis of exclusion: test everything, and if it all comes back normal, call it IBS. That is no longer what guidelines recommend, and the change puts more weight on the history.
The American College of Gastroenterology suggests a positive diagnostic strategy rather than a strategy of exclusion, specifically to improve the time it takes to start appropriate treatment (Lacy 2021). The British Society of Gastroenterology reclassified IBS as a disorder of gut-brain interaction rather than a "functional" disorder, and built its guidance around the same positive approach (Vasant 2021).
That recommendation came out of a real trial. In Denmark, 302 primary care patients aged 18 to 50 who met symptom criteria with no alarm signals were randomised either to a positive strategy (a blood count and CRP) or to a strategy of exclusion (extensive bloods, stool samples for parasites, and sigmoidoscopy with biopsies). At one year, quality of life was no worse in the positive group, symptoms and satisfaction were similar, and direct costs were lower. No cases of inflammatory bowel disease, colorectal cancer or coeliac disease turned up in either arm (Begtrup 2013). Five years later the researchers went back to the national registries: still no coeliac disease and no gastrointestinal or gynaecological cancers in either group, and the positive strategy had saved endoscopies overall (Engsbro 2021).
The practical consequence for you is blunt. Fewer tests are being run up front, so the history carries more of the load. A vague history now costs you more than it did twenty years ago.
You may have 11 seconds, so build the opener accordingly
The most uncomfortable evidence in this whole area is about how consultations actually run. Researchers analysed a random sample of 112 recorded clinical encounters. Clinicians elicited the patient's agenda, meaning they asked what the patient wanted to discuss, in 40 of 112 visits, which is 36%. It happened in 49% of primary care visits but only 20% of specialty care visits. And in 27 of those 40 encounters, the clinician interrupted after a median of 11 seconds. Patients who were not interrupted took a median of 6 seconds to say what they came for (Singh Ospina 2019).
Six seconds. That is roughly one sentence. So write one sentence that survives an interruption, and let the rest be follow-up.
A weak opener: "I've been having stomach problems for ages, it's really affecting my life, I've tried cutting out dairy and gluten and I'm not sure what else to do."
Everything in that sentence is true. None of it is diagnostic. It invites a reply about diet, and now you are ten minutes into a conversation about gluten.
A stronger opener: "For about eight months I've had lower abdominal cramping that eases after I open my bowels, with type 6 stools three to five times most mornings and urgency. No blood, no weight loss. I'd like to know whether this is IBS and what we're ruling out."
That is about twenty seconds. It gives the pain, its relationship to defecation, stool form, frequency, duration, two red flags explicitly excluded, and a stated goal. If you get interrupted at second eleven, the interruption will be about something useful.
People in r/ibs describe the time pressure exactly this way. One commenter in a thread about tracking symptoms put it plainly: appointments are quick, and doctors make decisions based on what we tell them, so being organised before you speak is the point (r/ibs thread).
Get the pain part right: three questions that decide the label
Abdominal pain is where the most diagnostic information sits, and it is also where people are vaguest. Three details matter more than any others.
1. Where is it, and does it move? IBS pain can be anywhere in the abdomen and often moves around. NICE specifically notes that this distinguishes it from cancer-related pain, which typically has a fixed site (NICE CG61). In a study of 568 consecutive patients having a full diagnostic work-up, pain that radiated outside the abdomen was associated with a diagnosis of IBS rather than organic lower gut disease, as was pain associated with looser bowel motions and pain occurring on six or more occasions in the previous year (Hammer 2004). So "it moves around and it's been happening most weeks for a year" is not a sign you are being imprecise. It is a finding.
2. What happens when you open your bowels? Better, worse, or no change. This single question appears in every version of the criteria. "It eases for an hour then comes back" and "going makes it worse" are both useful answers. "I don't know" is worth sitting with for a week and watching.
3. Is it continuous? This has become more important. Rome V, published in 2026, added a specification that abdominal pain in IBS should not be continuous, partly to separate IBS from centrally mediated abdominal pain syndrome (Corsetti 2026). In a UK registry analysis of 1,275 people who said they had IBS, 78% met Rome III criteria, 59% met Rome IV, and 70% met Rome V. Among those who met Rome III but not Rome V, the overwhelming majority reported continuous abdominal pain (Staller 2026).
So if your pain never fully goes away, say so, and say it clearly. It does not mean nothing is wrong. It means the label may not be IBS alone, and the treatment conversation should go somewhere different.
Describe stools by number, not by adjective
Use the Bristol Stool Form Scale. It is the fastest, least awkward and most precise language available, and clinicians use it routinely.
The scale runs from type 1 (separate hard lumps) to type 7 (entirely liquid). It was validated by measuring whole-gut transit time with radio-opaque markers in 66 volunteers and then changing transit with senna and loperamide. Stool form tracked transit better than stool frequency or stool weight did, both at baseline and when transit changed (Lewis 1997). That is why "mostly type 6" carries real physiological information in a way that "loose, I suppose" does not.
NICE explicitly suggests showing people the Bristol chart to help them describe bowel habit, and uses type 4 as the target when adjusting treatment (NICE CG61). Subtype (IBS with diarrhoea, with constipation, or mixed) is worked out from the proportion of your abnormal stools that are hard versus loose, so giving a rough split does the classification for your doctor in one sentence: "on bad days maybe 70% type 6 or 7, but I get a few type 2 days a month too."
There is one more thing NICE flags that almost nobody volunteers: about 20% of people experiencing faecal incontinence disclose it only if asked directly (NICE CG61). If it is happening to you, it belongs in the appointment. It changes how urgently you are treated and it is far more common than people think.
A translation table for the appointment
This is the core of it. The left column is how people usually describe things. The right column is the same information in the form that does diagnostic work.
| What people usually say | What actually helps | Why it matters |
|---|---|---|
| "My stomach's been bad for ages" | "It started in March, so about six months" | Duration thresholds sit inside every criteria set |
| "I get diarrhoea" | "Type 6, three to five times before midday, then nothing" | Form, frequency and timing separate subtypes and point to different causes |
| "I'm in pain all the time" | "Cramping most days, low down, eases after I go; a few pain-free days a week" | Whether pain is continuous now affects the diagnosis itself |
| "Certain foods set me off" | "Symptoms are worse within a few hours of eating, across a lot of different foods" | Symptoms worse after eating is a supporting feature; a long trigger list is a pattern, not a diagnosis |
| "It's been getting worse" | "Six months ago it was twice a week, now it's most days, and I've lost 4 kg without trying" | A changing trajectory plus weight loss is a red flag |
| "There was a bit of blood once" | "Blood mixed through the stool, four times in the last month" | Blood on paper and blood mixed in mean different things |
| "I'm exhausted" | "Tired and breathless on stairs, which is new" | Points towards checking for anaemia |
| "It's probably stress" | "It started two months after a stomach bug in Spain, and I get bad days on calm weeks too" | Post-infection onset and symptoms independent of stress are both informative |
Print it, or write your own version of the right-hand column on an index card. You do not have to perform it smoothly. You can read it.
The sentence most people leave out: how it started
Onset is a genuinely useful clinical fact and it is the thing most often skipped.
If your symptoms began after a bout of gastroenteritis or food poisoning, say so. In a meta-analysis of 45 studies covering 21,421 people who had infectious enteritis, 10.1% met criteria for IBS at 12 months, and the risk of IBS was about 4.2 times higher than in people who had not had an intestinal infection. For enteritis caused by protozoa or parasites, 41.9% went on to develop IBS (Klem 2017). Post-infection IBS is a recognised pattern, and saying "this started three weeks after a bad stomach bug" is more informative than almost anything else you could offer.
Equally: if this is not new, say how it has changed. "I've had a sensitive gut since my twenties, but the pattern changed completely in January" is a different presentation from "this has been exactly the same for fifteen years". The first one usually warrants a fresh look. The second one usually warrants a treatment plan.
Clairop logs meals, symptoms and stool in seconds, then looks for the foods your gut reacts to, including reactions that land days later.
What to say so the right tests get ordered
Different facts unlock different tests. If you know which fact triggers which test, you can make sure the relevant one gets said out loud.
| If this is true for you | The test that usually follows | What the evidence says |
|---|---|---|
| Diarrhoea is part of your picture | Coeliac blood tests (tTG or EMA) | Biopsy-proven coeliac disease was around 4% in people meeting IBS criteria in one meta-analysis, roughly four times the rate in controls |
| Diarrhoea is part of your picture | Faecal calprotectin | A normal result makes inflammatory bowel disease very unlikely |
| Watery diarrhoea persisting despite a clear work-up | Bile acid testing (SeHCAT where available) | Roughly a quarter to a third of people meeting IBS-D criteria have bile acid malabsorption |
| Watery diarrhoea, onset after 50, night-time stools, weight loss, a new medication, or an autoimmune condition | Colonoscopy with biopsies to look for microscopic colitis | Normal-looking bowel does not rule it out; only biopsies do |
| Pelvic pain, painful periods, pain with sex | Gynaecology review | IBS is around three times more common in women with endometriosis |
| Any red flag | Referral and further investigation | Covered in its own section below |
Coeliac disease. A meta-analysis of 14 studies and 4,204 individuals found biopsy-proven coeliac disease in about 4.1% of people meeting IBS criteria, with more than four times the odds compared with controls (Ford 2009). An update covering 36 studies and 15,256 people confirmed the raised odds overall, though it found no increase in North American studies specifically, so the value of screening varies by setting (Irvine 2017). The most recent analysis, of 29 studies and 7,209 people with Rome III or Rome IV IBS, found pooled coeliac seroprevalence of 6% and biopsy-proven coeliac disease of 2%, and concluded that a positive diagnosis of IBS should not be made without excluding coeliac disease (Shiha 2025). Notably, 15% of people who tested seropositive never went on to biopsy. If you had a positive blood test years ago and nothing happened, that is worth raising. Do not remove gluten from your diet before testing, because that can make the tests unreliable; ask your doctor about timing first.
Inflammatory bowel disease. ACG suggests faecal calprotectin in suspected IBS with diarrhoea (Lacy 2021). A meta-analysis found that a CRP of 0.5 mg/dL or below, or a calprotectin of 40 µg/g or below, left a 1% or lower probability of IBD (Menees 2015). A later meta-analysis of 17 studies and 1,956 patients found calprotectin had 85.8% sensitivity and 91.7% specificity for distinguishing IBD from IBS, with a negative predictive value of 99.8% at realistic disease prevalence (Dajti 2023). A normal calprotectin is genuinely reassuring. A mildly raised one is common and usually not IBD, so try not to read it alone.
Bile acid diarrhoea. This is the one that comes up constantly in patient communities and gets missed most often. A systematic review of 18 studies and 1,223 people with IBS-D type symptoms found 10% had severe bile acid malabsorption on SeHCAT testing and 32% had moderate malabsorption (Wedlake 2009). A later meta-analysis of six studies and 908 people put the pooled rate at 28.1% (Slattery 2015). The r/ibs archive is full of people who spent a decade with an IBS-D label before this was tested, including one long account from someone diagnosed at 63 after 35 years (r/ibs thread). Those stories are not evidence of how common it is. The meta-analyses are, and they say it is common enough to ask about. Availability of testing varies by country, so ask what your service uses.
Microscopic colitis. In a French prospective study of 433 people with chronic diarrhoea and a normal or near-normal colonoscopy, 129 turned out to have microscopic colitis on biopsy. The independent predictors were age over 50 (odds ratio 3.1), night-time stools (2.0), weight loss (2.5), diarrhoea lasting under 12 months (2.0), recent introduction of a new drug (3.7) and a known autoimmune disorder (5.5) (Macaigne 2014). If several of those fit you, say them together rather than one at a time.
And the test you probably do not need. NICE lists colonoscopy among the investigations not necessary to confirm IBS in people who meet the criteria (NICE CG61). In a US study comparing 466 people with suspected non-constipation IBS against 451 people having screening colonoscopy, the suspected IBS group had fewer adenomas (7.7% versus 26.1%) and no higher rate of structural abnormalities. Microscopic colitis was found in 1.5% overall, and 2.3% of those aged 45 and over (Chey 2010). Knowing this helps you ask a better question than "can I have a colonoscopy": ask what would make your doctor want to look.
Red flags: say these first, not last
These are the symptoms that change the plan, and they should come out of your mouth in the first minute whether or not anyone asks. If any of them are new for you, see a doctor promptly rather than waiting for a scheduled appointment.
- Blood in your stool, especially mixed through it rather than on the paper
- Unintended weight loss
- A change in bowel habit starting at around 50 or later
- Symptoms that wake you from sleep, including night-time stools
- Fever
- Feeling unusually tired or breathless, which can point to anaemia
- A family history of bowel cancer, coeliac disease or inflammatory bowel disease
- A hard lump in your abdomen or rectum
It helps to know how these actually perform, because the fear around them is often out of proportion. In a multicentre study of 730 people with suspected IBS who all had colonoscopy, alarm symptoms were present in 75.3%, but organic disease was found in only 10.4%. The alarm features with the highest positive predictive value for organic disease were anaemia (22.9%), faecal occult blood (19.4%) and unintended weight loss (16.5%) (Yang 2022). In the earlier Australian work, symptom onset at 50 or over roughly doubled the odds of organic lower gut disease, as did blood on the toilet paper (Hammer 2004).
So: most people with an alarm symptom do not have serious disease, and that is genuinely reassuring. But those symptoms are still the ones that earn a closer look, and the only way they earn it is if you say them. Our GI appointment preparation guide goes through the practical run-up in more detail.
How to ask for more tests without derailing the appointment
The single most effective change is to swap a general doubt for a specific request. "Could it be something else?" is easy to answer with "unlikely". "Have I had coeliac serology, and is bile acid testing available here?" is not, because it asks about a named thing with a named test.
Three framings that work:
- "What did we rule out, and how?" This is a reasonable question and it forces the reasoning into the open. It also tells you whether a test you assume was done actually was.
- "What would make you want to reconsider this diagnosis?" This converts a closed conversation into a follow-up plan. Ask for the answer in the notes.
- "I've read that [X] can look like IBS. Is that worth checking in my case?" Naming the condition invites an explanation rather than a brush-off.
Be prepared for the answer to be no, and for that to be reasonable. The Danish trial data above is a real finding: in 302 people meeting criteria without alarm signals, extensive testing found no IBD, no cancer and no coeliac disease, and five years of registry follow-up did not change that (Begtrup 2013, Engsbro 2021). Most reinvestigation of a straightforward IBS picture finds nothing. That is not the same as saying nobody is ever missed, and the subgroups above are exactly where the yield sits.
A widely upvoted r/ibs post argues that IBS is a "bucket diagnosis" and lists dozens of conditions that can hide inside it (r/ibs thread). Another thread asks whether doctors simply label everything IBS rather than looking further (r/ibs thread). The feeling behind those posts is real and worth respecting. The useful response is not to reject the diagnosis wholesale, because IBS is genuinely common: pooled global prevalence is around 3.8% under Rome IV criteria and 9.2% under Rome III (Oka 2020), and more than 40% of people worldwide meet criteria for at least one disorder of gut-brain interaction (Sperber 2021). Most people with IBS symptoms really do have IBS. The useful response is to check the specific things that are both plausible for you and testable.
What to say about stress without handing over the whole explanation
This is the conversation people dread most, and the one where the two sides are most often talking past each other.
The association is real. A meta-analysis of 73 studies found anxiety symptoms in 39.1% of people with IBS and depressive symptoms in 28.8%, with roughly three times the odds compared with people without IBS (Zamani 2019). So when a doctor asks about stress, they are following the evidence, not dismissing you.
The problem is what happens next. A qualitative study interviewing 12 doctors and 14 patients found that doctors hold two definitions of IBS: a "public" one resembling the textbook, and a "private" one carrying accumulated frustration and assumptions about IBS patients. Patients, meanwhile, reported feeling labelled as neurotic, stigmatised and let down. The authors concluded that better outcomes come when doctors offer patients empowering explanations rather than dismissive ones (Dixon-Woods 2000). The Rome Foundation explicitly listed reducing imprecise and stigmatising terminology as one of the aims of its 2026 revision (Drossman 2026).
Two phrases help here.
Give the sequence. "The symptoms came first. The anxiety came after a year of not being able to leave the house without planning toilets." That is a different causal story and it is usually the accurate one.
Give the exceptions. "I also get bad days on quiet weekends when nothing is going on." This makes it harder to treat stress as the complete explanation while still leaving it on the table.
And it is worth separating dismissal from treatment. Gut-directed psychotherapy, including gut-directed hypnotherapy and cognitive behavioural therapy adapted for IBS, is a suggested treatment in the ACG guideline based on the evidence, not a way of saying it is in your head (Lacy 2021). If it is offered, "is this instead of investigating, or alongside?" is a fair question.
One more thread worth pulling. Women report being dismissed more often, and there is a literature on it: a widely cited analysis argued that women in pain are more likely to be taken less seriously and less likely to be treated aggressively than men with the same complaints (Hoffmann 2001). There is also real diagnostic overlap. A meta-analysis of 11 studies found the odds of IBS were about 3.3 times higher in women with endometriosis than in women without (Chiaffarino 2021). If your pain tracks your cycle, is worse with periods, or comes with pain during sex, say that explicitly; it is the detail that gets a gynaecology referral considered. Our guide on why IBS gets worse around your period goes into how to separate the two patterns.
A worked example: the same ten minutes, twice
Maya, 34, six months of symptoms, first GP appointment about it.
Version one. She opens with "I've had really bad stomach problems for months and I think it might be IBS, I've tried cutting out dairy and it didn't help." The GP asks about diet, then about stress at work, which is high. They discuss fibre, suggest trying a low FODMAP approach, and book a review in eight weeks. Maya leaves with a leaflet. She mentions at the door that she has lost some weight, and the appointment is already over.
Version two. Same person, same symptoms, different first sentence.
"Since March I've had cramping across my lower abdomen most days. It eases after I open my bowels. Stools are mostly type 6, three to five times before lunch, with urgency. I've lost about 4 kg without trying. No blood. It started a few weeks after a bad stomach bug on holiday."
In thirty seconds the GP has: duration, pain site, the relationship to defecation, stool form, frequency, urgency, a red flag, a red flag excluded, and a post-infection onset. The conversation that follows is about the weight loss, coeliac serology, a calprotectin test, and whether the timing after gastroenteritis fits post-infection IBS. Diet is discussed, but second, and in the context of a plan.
Nothing about Maya changed. Nothing about her symptoms changed. The only difference is the order.
What she brought. Six weeks of logs showing stool form and frequency by day, weight recorded fortnightly, and a note of which days woke her at night. She did not read it out. She handed over one page and used it to answer questions accurately instead of estimating.
Put the facts on one page, in this order
Bring a single sheet, and put the facts in the order above rather than in the order they occurred to you: onset, pain, stools, red flags, weight, what you have tried, current medicines, family history. The sequence is the point. Two companion guides cover the surrounding logistics in depth, so this one will not repeat them: how to prepare for a GI appointment covers the two-week run-up and the preparation mistakes that quietly ruin your own test results, and questions to ask a gastroenterologist about IBS covers what to ask once you have finished describing.
One thing worth adding to whatever you write down: the misconceptions you may be carrying without realising. In a national survey of 1,242 people with IBS, 52% believed IBS is caused by a lack of digestive enzymes, 42.8% thought it was a form of colitis, 43% thought it could develop into colitis and 21.4% thought it could develop into cancer (Halpert 2007). If any of those are sitting at the back of your mind, writing the question down and asking it directly is worth more than nodding along, and it is a fast way to get an explanation rather than a label. Writing questions down in advance is not just tidiness: in a randomised trial of 58 patients attending surgical consultations, those given a written prompt list asked 24% more questions and recalled about 9% more information afterwards, with no increase in anxiety and no longer appointment (Ey 2023). It is a small trial in a different specialty, so treat it as suggestive rather than settled, but the intervention costs nothing.
If you want a structure for the log behind the page, our guide on how to keep a food diary for IBS covers what to record and for how long, and how to find out what triggers your IBS explains why a diary makes suspects rather than answers. Clairop produces a one-page summary for appointments from what you log, covering your bowel pattern, activity score and medication adherence, and the method page explains the thresholds it uses before it will show you a result.
If you already have an IBS diagnosis and something has changed
Re-presenting is a different conversation, and the framing that works is different too. The question is no longer "what is this", it is "what changed".
Say what the old pattern was, what the new pattern is, and when it switched. "For ten years it was constipation with cramping, maybe twice a week. Since May it has been loose stools five times a day and I'm waking at 3am." That is a description of a change in trajectory, which is the thing that reopens an investigation. "It's been bad again" is not.
Quantifying helps. The IBS Severity Scoring System runs from 0 to 500, with 75 to 175 counted as mild, 175 to 300 moderate, and above 300 severe. A change of 50 points reliably indicates real improvement or deterioration (Francis 1997). You do not need to score yourself formally, but the idea behind it is useful: give numbers that can move, not adjectives that cannot.
Our guide on why IBS comes and goes is worth reading before you decide a bad stretch is a new problem, because fluctuation is part of the condition and the distinction between a rough patch and a genuine change is exactly what your doctor will be trying to work out.
Myths that make this conversation harder
Myth: "IBS is a diagnosis of exclusion, so I need every test first." Guidelines now recommend the opposite. ACG suggests a positive diagnostic strategy to shorten the time to appropriate treatment (Lacy 2021), and a randomised trial plus five-year follow-up found it was as safe as extensive testing (Engsbro 2021).
Myth: "A normal colonoscopy means nothing is wrong." A normal colonoscopy rules out some things and not others. Microscopic colitis, for instance, is invisible to the eye and found only on biopsy (Macaigne 2014). Ask whether biopsies were taken.
Myth: "If I mention stress they'll stop looking." Some doctors do close down early, and the qualitative literature acknowledges that frustration on both sides is real (Dixon-Woods 2000). But anxiety is genuinely common in IBS (Zamani 2019), and concealing it removes a treatable factor. Give the sequence and the exceptions instead.
Myth: "An alarm symptom means cancer." In 730 people with suspected IBS who all had colonoscopy, alarm symptoms were present in three quarters, but organic disease was found in about one in ten (Yang 2022). Alarm symptoms earn a closer look. They are not a verdict.
Myth: "There's no treatment, so the appointment is pointless." There is a treatment guideline with multiple recommended options for both diarrhoea-predominant and constipation-predominant IBS, plus dietary and psychological therapies (Lacy 2021, Vasant 2021). And the consultation itself appears to carry effect: an attentive, unhurried one outperformed a neutral one in a randomised trial (Kaptchuk 2008).
Myth: "The doctor will work it out from examining me." With IBS, examination mainly rules things out. The history is the diagnosis, which is why the preparation is not optional.
Myth: "Cutting out gluten before the appointment will help me explain things." If coeliac disease has not been excluded, removing gluten first can make the blood tests unreliable. Ask about the order of testing before you change your diet.
When to see a doctor promptly
Book an appointment rather than waiting for a routine review if you notice:
- New blood in your stool, or more blood than usual
- Unintended weight loss
- A change in bowel habit that starts at around 50 or later
- Symptoms that wake you at night
- New or worsening abdominal pain, or pain that has become constant
- Feeling unusually tired or breathless
- A first-degree relative with bowel cancer, coeliac disease or IBD, alongside new symptoms
- Symptoms starting within weeks of a gut infection or a new medication
Seek urgent medical help the same day for severe abdominal pain, a swollen tender abdomen, persistent vomiting, passing a large amount of blood, a high fever, or signs of dehydration such as dizziness on standing or being unable to keep fluids down.
None of this is about performing your illness well enough to deserve attention. You should not have to earn a good consultation. But while the system is what it is, the most reliable lever you have is the order in which the facts come out, and that is entirely within your control. Write the first sentence down. Read it if you need to. For more on preparing for appointments, browse our doctor visit guides.
