When to refer to the pharmacist

•  All children 
•  Constipation alternating with diarrhoea
•  If the customer has noticed blood or mucus in their stools or if they are dark/tarry 
•  A major change in bowel habits, particularly if middle aged 
•  If any other medication is being taken 
•  If the problem is recurrent or has lasted longer than a week 
•  If the customer has lost weight unintentionally
•  Severe pain when passing stools 
•  If the customer has already tried a product and it hasn’t worked  
•  If the customer is pregnant 
•  If you suspect laxative abuse.

Whenever you talk to any customer, remember WWHAM:

Who is it for?

It may not be the customer who needs the treatment. Remember that children should be referred to the pharmacist. 

What are the symptoms?
Ask the customer to describe all of their symptoms. Anyone with blood in their stools should be referred to the pharmacist.  

How long have the symptoms been present?
If the problem is recurrent or symptoms have lasted longer than a week, the customer should be referred to the pharmacist. 

Action already taken?
This will help to establish whether the customer has tried to change their diet or has used a product that wasn’t appropriate or didn’t help.  

Medication? 
Some medicines can cause constipation. This should be ruled out before any treatment is recommended.

You don’t have to ask these questions in order, and a customer might give you some of this information without you asking. As long as you cover them all in some way, you should be able to find out the information you need in order to make a recommendation. The golden rule to remember is: if in doubt, refer to the pharmacist. Don’t be embarrassed to ask for their advice as they have a lot of information about products and symptoms to hand that you may not be aware of.