Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Get emergency help for sudden severe abdominal pain, fainting, vomiting blood, heavy rectal bleeding, confusion, or signs of shock such as pale, cold or clammy skin.
A child with severe episodic pain, repeated vomiting, unusual sleepiness or bloody stool also needs emergency assessment.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent medical care for worsening abdominal pain, repeated vomiting, marked abdominal swelling, or inability to pass stool or gas.
These may indicate a bowel blockage.
3
Does any of this apply?
Book an appointment
Arrange routine medical follow-up if you have PJS and:
Your surveillance appointments are overdue
Abdominal discomfort keeps returning
You notice small amounts of blood in your stool
You develop increasing tiredness or breathlessness
A new breast, testicular or abdominal lump appears
Your bowel habits change and do not return to normal
These symptoms have several possible causes, but they should be assessed rather than saved for a distant screening visit.
Every sign above is quoted from the sofidex article on Peutz-jeghers syndrome. If you are not sure, err upward — it is always reasonable to be checked.