Undiagnosed Rectal Bleeding

General points

• Patients with persistent low-risk symptoms which do not respond to treatment, or which recur after stopping treatment, should be referred.
  
  
• Please consider the most likely diagnoses and tailor referral urgency accordingly i.e. 2-week-wait or urgent or routine.

 

Colorectal 2 week wait criteria

RCHT 2WW Forms are available here

NB: the risk of having bowel cancer is never zero, even in patients without symptoms. Some cancers will be found incidentally in patients presenting with symptoms from benign disease, and symptomatic cancers can develop in patients who already have symptoms from functional bowel disease or piles. This means that patients with persistent low-risk symptoms which do not respond to treatment, or which recur after stopping treatment, should be referred to routine clinics.

 

Prior to referral

• Rectal examination
   
• qFIT – a measure of ‘colonic health’ – it is reassuring if negative in a patient with rectal bleeding, as is a pointer that the bleeding is of anal verge origin
   
• FBC, eGFR, CRP and ferritin

 

 

Review Date                    14/09/2022

Next Review Date            14/09/2022

Author                               Dr L Vines, RMS Clinical Editor

 

Version 2.1