REMEDY : BNSSG referral pathways

Rectal Bleeding

Checked: 20-12-2017 by Rob.Adams Next Review: 20-12-2018

Principles of Management

Prime Endoscopy have developed these guidelines for the management of Rectal Bleeding (word doc) using BSG and NICE guidelines.

There is also a good summary on rectal bleeding in adults in




Please see endoscopy section for advice on referral for lower GI scope.

Red Flags

Red flags for patients with rectal bleeding include:

Rectal or abdominal mass.

Patients aged under 50 with rectal bleeding and any of the following: abdominal pain, change in bowel habit, weight loss, iron deficiency anaemia.

Any patient aged 50 and over with unexplained rectal bleeding.

See lower GI 2WW guidelines for further information.