How a GP should investigate someone with possible MUPS
A GP will aim to rule out all the medical conditions that might be causing your symptoms. You will need a thorough physical examination, urine and blood tests, and relevant x-rays – to rule out those causes.
The following investigations should be undertaken as a minimum:
- Urinalysis for protein, blood and glucose
- Full blood count
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)
- Ferritin, B12 and folate
- Urea and electrolytes – for CKD
- Random blood glucose
- Bone biochemistry
- Liver enzymes
- Thyroid function (TSH)
- Tissue transglutaminase antibodies (tTG–IgA) for coeliac disease
- Creatine kinase
- Chest x-ray.
Further investigations may be indicated. For example, for persistent unexplained gastrointestinal symptoms in women, particularly for those aged over 50 years, CA125 should be measured.
Tests (and drug treatment) can be a ritual statement of the doctor’s interest in the patient and their symptoms. But not all patients will want medication. Listening is an important therapy and valued by patients.
Another patient said:
Above all, they must know how to listen and give the right amount of advice, without being aggressive or imposing, because these are aspects of a psychological nature and they need to be dealt with very calmly.
Common diagnoses which are sometimes missed include diabetes, coeliac disease, thyroid problems and autoimmune conditions.
