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They can be painful or tender, but are generally less severe than herpes outbreaks

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Seeds from the invasive species have been shown to be transported by the rivers to natural areas located downstream, thus building upon the already established dispersal distance of the plant

Primary care investigations Full history including menstrual history, GI history, medications, family history, dietary history Examination including abdominal exam looking for masses Ferritin If ferritin normal check iron and transferrin on a fasting blood sample If iron deficiency confirmed check coeliac screen Urinalysis for blood British Society of Gastroenterology Guidelines for the management of iron deficiency anaemia: