A practice in the Southend-on-Sea area

5. Miss B complains the Surgery failed to diagnose her with gallstones in February 2025. She says during this consultation, the GP was rude and dismissive. She also complains it prescribed her with medication for acid reflux from October 2024 incorrectly.

6. Miss B says due to the delay in diagnosis she has been living with ongoing nausea which affects her appetite and stomach pain as she is still awaiting an operation on her gallbladder.  She also says she has received a diagnosis of polyps which she believes may be due to overuse of the acid reflux medication.

7. She wants an acknowledgement of failings, service improvements and a financial remedy.

8. Miss B attended the Surgery at the beginning of February 2025 with stomach pain. During this appointment the Surgery changed her to different proton pump inhibitor (PPI) which is a type of medicine that reduces the amount of acid your stomach and made a referral to the endoscopy service.

9. Miss B then attended the Surgery for an unrelated gynaecological issue in mid-February which is when the Surgery referred her for an ultrasound. She attended an endoscopy procedure on 10 May and an ultrasound on 23 May. The ultrasound results showed an incidental finding of 30mm gallstone.

Diagnosis 12. Miss B complains the Surgery failed to diagnose her with gallstones when she attended the Surgery at the beginning of February with pain and cramping in her stomach and abdomen.

13. NICE guidance on dyspepsia (commonly referred to as indigestion, is a term used to describe discomfort or pain in the upper abdomen) says a clinician should arrange a referral for endoscopy and/or to a gastroenterologist, depending on clinical judgement.

14. Miss B appears to have a history of gastritis (inflammation of the stomach lining) diagnosed in 2019. At the beginning of February, she attended the surgery with pain in her upper mid-abdomen which she reported she had for five months.

15. Our clinical adviser explained Miss B’s examination revealed tenderness in the area which is the usual location for gastritis or dyspepsia pain. They went on to explain gallstone pain is typically more in the right upper quadrant (RUQ) area.

16. We have seen evidence the GP at the Surgery considered gallstone pain in their diagnosis. But as Miss B had no RUQ tenderness on examination, the GP deemed her symptoms to be ongoing gastritis. As she had previously had a stool sample to check for helicobacter pylori (a bacteria that lives in the stomach), it switched her to a different PPI which is a type of medicine that reduces the amount of acid your stomach makes and made a referral to endoscopy.

17. We therefore consider the Surgery acted in line with NICE guidance during this appointment as it considered both gallstone pain and dyspepsia during its examination of Miss B and made a referral to endoscopy for further investigation when dyspepsia appeared to be the likely cause of Miss B’s pain and discomfort.

18. We have seen Miss B attended the Surgery for a different reason in mid-February, and it referred her for an ultrasound scan which she had in late May with the results showing an incidental finding of a gallstone.

19. We recognise and are sorry for the upset and frustration she feels about not receiving a diagnosis for this at an earlier date. We appreciate how worrying and distressing ongoing symptoms can be. We hope our findings give her reassurance the Surgery did not get anything wrong in its actions at the beginning of February in relation to her symptoms, as the more likely diagnosis at that time based on where she said her pain was, was dyspepsia. We will therefore take no further action on this part of the complaint.

Communication 20. Miss B complains during the consultation at the Surgery at the beginning of February, the GP was rude and dismissive.

21. She told us that during her consultation with the Surgery in early February she felt the GP dismissed her concerns over her symptoms and family history of gallstones and the amount of pain she was in.

22. While we can sympathise with the experience Miss B has told us about, and how it made her feel at the time, we were not present during these interactions so we cannot say the Surgery was dismissive or rude in its behaviour to her. As such, we are unable to judge what the Surgery might have said or in what context. But it is clear she was unhappy with how it spoke to and treated her.

23. We would like to be able to conduct a meaningful investigation of this complaint, but we would not be able to reach a decision as there is no objective evidence. Therefore, we will not take any further action on this part of the complaint.

Medication 24. Miss B complains the Surgery prescribed her with antacid medication incorrectly in October 2024. Miss B is worried this may have led to the polyp another organisation found during her endoscopy procedure in early May 2025.

25. NICE guidance on dyspepsia says a clinician should prescribe a PPI medication and test for helicobacter pylori if the person’s status is not known or uncertain.

26. As we mentioned earlier, Miss B had a history of gastritis following an endoscopy procedure and diagnosis in 2019. When she attended the Surgery in October, the GP noted Miss B had responded well to PPI medication in the past so prescribed Omeprazole (PPI medication) and ordered the test to check for helicobacter pylori.

27. We consider these actions by the Surgery to be in line with the NICE guidance above. We recognise Miss B’s concerns that the prescription of this medication may have caused polyps.

28. Our clinical adviser explained the results of Miss B’s gastroscopy showed a lesion on her stomach which showed no features of concern and not a polyp. We were also pleased to see that the organisation recommended continued use of PPI to relieve her symptoms. We hope this will reassure Miss B the Surgery’s actions in relation to the prescribing of this medication was in line with relevant guidance and we will therefore take no further action on this part of the complaint.

Conclusion

29. We were very sorry to hear about Miss B’s overall experience, and we recognise how worrying and upsetting ongoing symptoms can be. We understand this has been a difficult time for her, and we do not underestimate the impact this will have had on her daytoday life and peace of mind.

30. Having carefully considered the information available, we hope our findings will offer some reassurance that the Surgery did not get anything wrong in its actions in relation to her symptoms or the prescription of her medication. While we appreciate this may be disappointing for her, we will not take any further action on this complaint.

1. We have carefully considered Miss B’s complaint about the Surgery. We were sorry to hear about her experience and the difficulties she continues to face with her ongoing symptoms. We have looked at all the evidence provided to us by Miss B and the Surgery.

2. We have seen that the Surgery followed relevant guidance in relation to how it managed her symptoms during a consultation in early February 2025 and in its decision to prescribe medication in October 2024. We will therefore take no further action on this part of the complaint.

3. We have also looked at the Surgery’s communication with Miss B during her attendance at the beginning of February, we were unable to reach a decision on this part of her complaint as there is no objective evidence we could refer to. We will therefore take no further action on this part of the complaint.

4. We are sorry for any additional upset this may cause, and we hope our explanations below explain how we have fully considered this.