Investigations	Potential results	Clinical management plan: abnormal results

Check haemoglobin and RBC indices Check clotting and haematinics if heavy bleeding has occurred	Abnormal	Follow treatment for abnormal blood results (pages 2–3).
OGD and colonoscopy	Radiation-induced telangiectasia in the colon or terminal ileum	*Do not biopsy* irradiated areas. Optimise bowel function and stool consistency. If bleeding is not affecting quality of life, reassure. If bleeding affects quality of life, stop/reduce anticoagulants if possible and consider oral sucralfate. Discuss and refer to a specialist centre for treatment to ablate telangiectasia: hyperbaric oxygen therapy thermal therapy, eg, APC Consider referral to a specialist centre for experimental therapy within the context of a clinical trial: thalidomide, vitamin A, tranexamic acid, RFA.
	Primary inflammatory bowel disease	Send stool culture. If mild or moderate, refer within 2 weeks to a gastroenterologist. If severe, *this is an emergency*—discuss immediately with a gastroenterologist.
	Diverticular bleeding	*This is an emergency* Discuss immediately with a GI surgeon.
	Upper GI source for bleeding	*This is an emergency* Discuss immediately with a gastroenterologist.
	Newly diagnosed neoplasia 2nd primary/tumour recurrence/advanced polyp	Refer urgently to the appropriate oncology team requesting an appointment within 2 weeks.
	If all tests are negative, but symptoms persist	Discuss with supervising gastroenterologist. Consider capsule endoscopy (following use of a patency capsule—high risk of strictures). Consider angiography. Ask GP to monitor Hb as clinically indicated.

APC, argon plasma coagulation; GI, gastrointestinal; GP, general practitioner; OGD, oesophago-gastroduodenoscopy; RBC, red blood cell; RFA, radiofrequency ablation.