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[DOI] [PubMed] [Google Scholar] Riley 2011 Riley RD, Higgins JP, Deeks JJ

Demographic and baseline characteristics Vital parameters including temperature, heart rate, respiratory rate, and blood pressure were recorded at the screening visit and subsequent visits

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You should seek medical advice if you experience: Persistent constipation that is not improving after trying self-care measures for a few weeks Blood in your stools (either bright red or dark, tar-like stools) Unexplained weight loss accompanying bowel changes Severe abdominal pain or bloating that is worsening or persistent Alternating constipation and diarrhoea that is persistent or recurrent A significant change in your normal bowel pattern, particularly if you are aged 60 or over with change to looser or more frequent stools, or aged 50 or over with unexplained rectal bleeding Symptoms of bowel obstruction such as inability to pass wind, severe cramping, or vomiting According to NICE guidance , these features may indicate conditions requiring investigation, including colorectal cancer, inflammatory bowel disease, or other gastrointestinal disorders