Mr Evans recently underwent an upper GI endoscopy to investigate abdominal pain and bloating. Duodenal biopsies and serology tests have confirmed coeliac disease. Explain the diagnosis to him and how it should be managed.
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The ideal candidate will: • acknowledge the grievance but explain the non-specific symptoms of coeliac disease and their similarity with common dyspepsia; delays in diagnosis are common • will attempt to draw focus away from the delay in diagnosis towards the management of the condition • will give a clear management plan.
This is a scenario of an angry patient who is accusing his own GP of ignoring his symptoms and not taking him seriously. He feels he has had to diagnose himself. The candidate explains coeliac disease can present nonspecifically and a delayed diagnosis is not uncommon. The candidate has empathy for the journey the patient has been through. The patient’s main concern is the fact that he has been ignored. The candidate expertly acknowledges this concern but says he will deal this diagnosis first and come back to his concerns later. The candidate offers to speak to the GP about the patients concerns and gives a balanced view towards a potential missed diagnosis. He quite rightly mentions the avenue of PALS (Patient Advice and Liaison Service) if this is something the patient wishes to do.
Coelic Disease - Examiner role play.pdf
Coelic Disease - Candidate roleplay.pdf