Investigations | Potential results | Clinical management plan: abnormal results |
---|---|---|
Medication assessment | On nicorandil | Liaise with cardiology team and GP to offer alternative medication. |
Visual assessment 1st Line Anoscopy and flexible sigmoidoscopy 2nd Line MRI | Haemorrhoids |
|
Anal fissure |
| |
Anorectal fistula |
| |
Anorectal abscess | This is an emergency Discuss immediately with a colorectal surgeon regarding treatment with antibiotics and/or drainage. | |
Anorectal ulcer | Check patient is not on nicorandil. | |
Mucosal prolapse/solitary rectal ulcer | Refer to GI surgeon/gastroenterologist. | |
Neoplastic ulcer | Refer urgently to appropriate oncology team requesting an appointment within 2 weeks. | |
If radiation-ulceration related | Do not biopsy
| |
If all tests are negative, but symptoms persist |
|
GI, gastrointestinal; GP, general practitioner; GTN, glyceril trinitrate.