| Investigations | Potential results | Clinical management plan: abnormal results |
|---|---|---|
| 1st Line | ||
| Routine AND additional blood screen (pages 2–3) | Abnormal results | Follow treatment of abnormal blood results (pages 2–3). |
| OGD and duodenal aspirate and biopsies and/or glucose hydrogen methane breath tests | SIBO | Treatment for SIBO (page 17). |
| Enteric infection | Treat as recommended by microbiologist. | |
| Carbohydrate challenge | Carbohydrate malabsorption | Treatment for carbohydrate malabsorption (pages 16–17). |
| If borgorygmi are present in combination with other symptoms: flushing, abdominal pain, diarrhoea, wheezing, tachycardia or fluctuation in BP | ||
| 2nd Line | ||
| Fasting gut hormones + Urinary 5-HIAA + CT scan chest, abdomen and pelvis | Functioning NET, eg, carcinoid syndrome or pancreatic NET | Discuss and refer urgently to the appropriate neuroendocrine tumour team requesting an appointment within 2 weeks. |
| If all tests are negative, but symptoms persist | Reassure. | |
OGD, oesophago-gastroduodenoscopy; NET, neuroendocrine tumour; SIBO, small intestinal bacterial overgrowth.