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NICE guidance (NG12) recommends urgent referral for investigation of dysphagia at any age Persistent vomiting that prevents adequate fluid or food intake, risking dehydration Vomiting blood (haematemesis) or passing black, tarry stools (melaena), which may indicate gastrointestinal bleeding New or significantly worsened heartburn or regurgitation that does not respond to usual reflux medications Right upper quadrant pain, fever, or jaundice , which may indicate gallbladder disease (cholelithiasis or cholecystitis) Severe abdominal pain with bloating and constipation , which could suggest intestinal obstruction or ileus Unexplained weight loss beyond expected therapeutic effects, or inability to maintain adequate nutrition

If youre still eating the exact amount you started with, that number may now be too high to keep losing weight, and a slight calorie adjustment could help you get moving again

Do 2 sets of 10-15 reps

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