Commissioning guide: Rectal Bleeding: Royal College of Surgeons (RCS) and ACPGBI, 2017
07 February 2018
This guidance applies to the elective management and onward referral for diagnosis, investigation and
management of patients who experience rectal bleeding.
This guidance does not supersede cancer pathways. It is not intended to guide commissioning of
services relating to suspected cancer, investigation of occult gastrointestinal bleeding (eg iron deficiency
anaemia) or emergency management of lower gastrointestinal haemorrhage. However, these pathways
will be referenced as rectal bleeding may be a sign of colorectal cancer or gastrointestinal haemorrhage.
This guidance does not refer to asymptomatic patients who are tested in the NHS Bowel Cancer
Screening Programme (BCSP).
Commissioning Guide for Rectal Bleeding
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