PR Bleeding and/or Haemorrhoids
The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form. This is part of routine waitlist auditing to ensure patient details are up to date. If you receive this SMS, please update your details.
Availability
North 
South North West Statewide 
This condition is treated in the General Surgery clinic
Pre-referral work-up
History
All referrals should comply to referral standards and include in particular:
- Refer for colonoscopy if underlying disease is suspected
- Points for concern:
- An associated change in bowel habit
- Blood mixed with stool
- Palpable mass on rectal examination
- Associated pain and discomfort in the absence of thrombosis or other pathology such as a fissure
- Copious bleeding with associated anaemia
- Note if there is any high risk family history
- If possible please complete the PR Bleeding Patient Questionnaire and include with your referral. This questionnaire can be downloaded as a PDF version or using the PHT referral template which you can download into your practice software.
Tests
- PR examination and results
- Check for prolapse and thrombosis of haemorrhoids
- Include if any, level of suspicion of underlying malignancy
Interim/GP management
To refer a patient with this condition, please see the General Surgery clinic page for the full referral process and templates.
Symptom management advice should be offered for patients without suspicious symptoms.
Review patients if symptoms change.
Related information found in the Gastroenterology and Colorectal Surgery guidelines.
For more information please see the Tasmanian Health Pathways website.
Urgent / category 1
Blood mixed in with stool
Anaemia
Pain
Weight loss
Abdominal mass
Iron deficiency anaemia
Semi-urgent / category 2
Change in bowel habit (to looser stools and/or increased frequency of defecation persistent for 6 weeks)
High risk family history (1st degree relative <50 years of age at onset of colorectal cancer OR more than one 1st degree relative with colorectal cancer)
Where there has been a recent benign colonoscopy and unexplained or recurrent rectal bleeding or a Positive FOBT
Routine / category 3
< 40 years of age with chronic haemorrhoidal type bleeding (no change in pattern)
Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
Proceed to Emergency Department (ED).
LGH ED Reception – Phone: (03) 6777 6405 Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120 Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100 Fax: (03) 6173 0489
Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.
For urgent referrals call the RHH switch on 6166 8308 and ask for the nurse in charge of surgical clinics or the relevant consultant to expedite the consultation.
We will endeavour to see these patients within four weeks, or sooner if clinically indicated.
We will endeavour to see these patients within 12 weeks
Next available appointment
