Name: Steve Murphy

DOB: DD/MM/YYYY

Age:64

• You have convinced yourself that you have bowel cancer, bleak outlook on your life, if you were to be told that you have a different diagnosis you would be very emotional and grateful

• I: You are convinced you have bowel cancer
• C: You are very concerned about the blood in the stool, you are convinced that you have bowel cancer just like your brother and probably your father too
• E: You want to know if you can be given anything right now to help with your symptoms

• You went to see your GP as you have been constipated and have noticed some blood in your stool which has worried you

Positive symptoms:

• Pain:

  • Pain at back passage only when sat on the toilet
  • Started with pain, other symptoms followed on
  • Pain on defecation
  • Sharp in nature
  • No radiation of pain
  • 5/10 severity
  • Itching around anus present -- embarrassed to say, thought it was due to poor wiping
  • No abdominal pain
• Symptoms for past month
• Fullness at back passage
• Always been constipated, have never seen blood in the toilet before
• Frequently spend up to 20-30 minutes sat on the toilet, takes along time to empty bowels completely
• Stools are very dry, small, rabbit-dropping like
• Stool has NEVER been black in colour
• Past month have seen drips of blood in the pan
• Blood is red in colour
• Maximum one teaspoonful of blood
• Never happened before

Negative symptoms:

• No change in bowel habits
• No diarrhoea or vomiting
• No symptoms of anaemia
• No mucus in stool
• No urological symptoms
• No systemic symptoms e.g. fevers, weight loss, loss of appetite or rashes

• Hypertension
• Type 2 diabetes
• Nil other PMHx

• Amlodipine, ramipril, metformin
• No other medication
• No known drug allergies

• Brother 62y/o recently diagnosed with bowel cancer
• Father 66y/o died at similar age, never knew the cause
• No other significant family history

• Smoked one packet a day for 10 years -- STOPPED 30 years ago
• Social drinker -- few pints a week at the pub
• No recreational drug use
• Retired landscape architect
• No effect on day to day life
• Live with wife and two dogs
• Fit, strong and athletic man
• No recent travel
• No contacts who have been unwell recently
• Poor fluid intake, frequently feel dehydrated
• Diet is classic British food, don't like the taste of much else