A 70-year-old man presents with stomach cramps and diarrhoea that has lasted 6 days after returning from South America. He takes ramipril and naproxen. What is the most appropriate course of action?

• A. Start self-treatment with antidiarrheal at home
• B. Seek immediate hospital admission
• C. Refer the patient to GP appointment for further investigation and treatment
• D. Stop all medications and fast

Answer: (C)

The situation calls for medical review rather than home treatment because travel-related diarrhoea lasting several days in an older adult raises red flags for dehydration or an invasive infection that needs assessment and potentially targeted therapy. At age 70, the risk of dehydration, electrolyte disturbances, and complications is higher, so a GP visit is appropriate to evaluate hydration status, obtain history and examination, and decide if stool testing or treatment is needed. The GP can provide rehydration guidance and consider antibiotics or other interventions if an infectious cause is suspected.

Self-treating with an antidiarrhoeal at home could mask symptoms and might be inappropriate if the infection is invasive or if there are warning signs. Immediate hospital admission is only necessary if there are signs of severe dehydration, sepsis, or other urgent complications. Stopping all medications and fasting does not address the underlying issue and could worsen dehydration or electrolyte imbalance, especially with ongoing NSAID use.