Investigations | Potential results | Clinical management plan: abnormal results |
---|---|---|
Check haemoglobin, RBC indices and platelets Check clotting and haematinics if heavy bleeding has occurred | Abnormal | Follow treatment for abnormal blood results (pages 2–3). |
Flexible sigmoidoscopy | Radiation proctopathy with bleeding from telangiectasia |
|
Haemorrhoidal bleeding | If not affecting quality of life, reassure. Consider local treatment of haemorrhoids (diet, topical creams). Consider surgical referral for 3rd degree haemorrhoids. | |
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 | |
Viral infection (eg, CMV) | This is an emergency Discuss immediately with a gastroenterologist. | |
Newly diagnosed neoplasia second 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 |
|
APC, argon plasma coagulation; CMV, cytomegalovirus; GI, gastrointestinal; GP, general practitioner; RBC, red blood cell; RFA, radiofrequency ablation.