Low Risk GI Bleeds

Patients with benign anorectal causes of lower GI haemorrage can often be managed as an outpatient.

Patients with anal fissures can normally be discharged home from the emergency department with adequate analgesia, advice regarding diet and water intake or faecal softening agents.

Patients with haemorrhoids (if otherwise stable) can usually be safely discharged home from the emergency department with faecal softening agents. However, they may need further investigation to rule out a more sinister cause for bleeding which will be indicated by the patient’s age, other history and physical findings on examination. These investigations, however, can often be performed as an out patient.

Learning bite

These patients must all have a digital rectal exam (strong recommendation) [15].