Investigations | Potential results | Clinical management plan: abnormal results | |
---|---|---|---|
Dietary assessment | Excessive dietary fibre intake |
| |
Rectal examination | Haemorrhoids | Stool bulking/softening agent. ± short-term topical local anaesthetic. | |
Anal lesion Rectal lesion | Refer urgently to a GI surgeon. | ||
Refer for a flexible sigmoidoscopy within 2 weeks. | |||
Flexible sigmoidoscopy | Anorectal ulcer | Determine patient is not on nicorandil for angina. | |
Neoplastic | Refer urgently to the appropriate oncology team requesting an appointment within 2 weeks. | ||
Rectal mucosal prolapse | Refer to a GI surgeon. | ||
Traumatic ulceration/solitary rectal ulcer syndrome | Refer to a gastroenterologist. | ||
If radiation-ulceration related | Do not biopsy
| ||
Carpet villous adenoma | Refer for endoscopic removal. | ||
Newly diagnosed neoplasm | Refer to the appropriate oncology team requesting an appointment within 2 weeks. | ||
IBD |
| ||
OGD and D2 aspirate and/or glucose hydrogen (methane) breath test | SIBO | Treatment for SIBO (page 17). |
GI, gastrointestinal; IBD, inflammatory bowel disease; OGD, oesophago-gastroduodenoscopy; SIBO, small intestinal bacterial overgrowth.