Bowel cancer symptom checker

Do you have any symptoms?

Bowel cancer is a general term for any cancer that begins in the large bowel. It is one of the four most common types of cancer in England after breast, prostate and lung.


There are three key symptoms you need to look out for. Use this symptom checker to find out if your symptoms require further investigation.

Questions

  1. How old are you?
    1. I'm under 50 years old
    2. I'm 50 or over
  2. What is your main symptom? (Only answer this question if you answered A to question 1)
    1. Rectal bleeding
    2. A change in bowel habit
    3. Abdominal pain or discomfort
    4. Another symptom (Add 5 points)
  3. What is your main symptom? (Only answer this question if you answered B to question 1)
    1. Rectal bleeding
    2. A change in bowel habit
    3. Abdominal pain or discomfort
    4. Another symptom (Add 6 points)
  4. Have you also had a change in bowel habit? (Only answer this question if you answered A to question 2)
    1. I have had no change in bowel habit
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: It's probably from piles.
    2. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The rectal bleeding is probably from piles, caused by your constipation.
    3. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating less fibre and taking a bowel sedative to reduce the number of times you go to the toilet. If you have any pile symptoms, try cleaning around the anus carefully and use creams and suppositories. A pharmacist can advise on suitable treatments.
    4. I have a change in bowel habit that is different from the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the result of something you have eaten or a mild gut infection.
  5. Have you had any symptoms of piles? (Only answer this question if you answered A to question 4 or D to question 4)
    1. I have pile symptoms
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating more fibre to make your stools softer and easier to pass. It is normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully and, if necessary, use creams and suppositories for your pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed, your GP is likely to advise referral to a routine hospital clinic.
    2. I don't have pile symptoms
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating more fibre to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  6. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered C to question 4)
    1. Less than four weeks
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
    2. More than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
  7. How long have you had rectal bleeding? (Only answer this question if you answered A to question 3)
    1. Less than four weeks
    2. More than four weeks
  8. Have you also had a change in bowel habit? (Only answer this question if you answered B to question 7)
    1. I have had no change in bowel habit
      • Cause of your symptoms: It's probably from piles.
    2. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Cause of your symptoms: The rectal bleeding is probably from piles, caused by your constipation.
    3. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
    4. I have a change in bowel habit that is different from the other options
      • Cause of your symptoms: It's probably from piles.
  9. Have you also had a change in bowel habit? (Only answer this question if you answered A to question 7)
    1. I have had no change in bowel habit
      • Cause of your symptoms: It's probably from piles.
    2. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Cause of your symptoms: The rectal bleeding is probably from piles, caused by your constipation.
    3. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
    4. I have a change in bowel habit that is different from the other options
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the result of something you have eaten or a mild gut infection.
  10. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered C to question 8)
    1. Less than four weeks
      • Advice: See your GP Your persistent bleeding may be being caused by piles, but it is worth discussing this with your GP as people over 50 are more likely to have easily removable polyps, which, if left, could develop into more serious problems in the future.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    2. More than four weeks
      • Advice: See your GP Your persistent bleeding may be being caused by piles, but it is worth discussing this with your GP as people over 50 are more likely to have easily removable polyps, which, if left, could develop into more serious problems in the future.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
  11. Have you had any symptoms of piles? (Only answer this question if you answered A to question 9 or D to question 9)
    1. I have symptoms of piles
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating more fibre to make your stools softer and easier to pass. It is normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully and, if necessary, use creams and suppositories for your pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have symptoms of piles
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating more fibre to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  12. Have you had any symptoms of piles? (Only answer this question if you answered A to question 8)
    1. I have pile symptoms
      • Advice: See your GP Your persistent bleeding may be being caused by piles, but it is worth discussing this with your GP as people over 50 are more likely to have easily removable polyps, which, if left, could develop into more serious problems in the future.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: See your GP Your persistent bleeding may be being caused by piles, but it is worth discussing this with your GP as people over 50 are more likely to have easily removable polyps, which, if left, could develop into more serious problems in the future.
      • What your GP might do: If you are over the age of 60, your GP may refer you to a hospital clinic within the next two weeks. If you're under 60 you will probably have an examination of your bottom and tummy and a blood test for iron deficiency anaemia. Even if these are normal it is still likely you will be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  13. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered C to question 9)
    1. Less than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating less fibre and taking a bowel sedative to reduce the number of times you go to the toilet. If you have any pile symptoms, try cleaning around the anus carefully and use creams and suppositories. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    2. More than four weeks
      • Advice: See your GP. Your rectal bleeding could be from piles and your change in bowel habit could be caused by a mild gut infection but it is worth discussing your symptoms further with your GP.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
  14. Have you also had bleeding from your bottom (rectal bleeding) in addition to the change in bowel habit?

    (Only answer this question if you answered B to question 2)
    1. I also have rectal bleeding
    2. I don't have any rectal bleeding
  15. Please describe how your bowel habits have changed (Only answer this question if you answered A to question 14)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Cause of your symptoms: The rectal bleeding is probably from piles, caused by your constipation.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try some simple treatments, if you haven't tried them before. If you have and they don't work, see your GP. Otherwise, try eating less fibre and taking a bowel sedative to reduce the number of times you go to the toilet. If you have any pile symptoms, try cleaning around the anus carefully and use creams and suppositories. A pharmacist can advise on suitable treatments.
    3. I have a change in my bowel habit that is different from the other options
  16. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 15)
    1. Less than four weeks
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
    2. More than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
  17. Have you had any symptoms of piles? (Only answer this question if you answered A to question 15)
    1. I have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Treatment: Try eating more fibre and taking laxatives to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed, your GP is likely to advise referral to a routine hospital clinic.
    2. I don't have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Treatment: Try eating more fibre and taking laxatives to make the stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  18. How long have you had a change in bowel habit? (Only answer this question if you answered B to question 14)
    1. Less than four weeks
    2. More than four weeks
  19. Please describe how your bowel habits have changed: (Only answer this question if you answered A to question 18)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: Your constipation is unlikely to have a serious cause, particularly if you don't have any abdominal pain. If you do, go back to the beginning of the checker and click on abdominal pain.
      • Treatment: It is safe to see if you get better with simple treatments. Try eating more fibre and taking laxatives to make your stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to have constipation, your GP is likely to advise referral to a routine hospital clinic.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: Your change in bowel habit is probably caused by the after-effects of a mild gut infection.
      • Treatment: It is safe to try some simple treatments. Try eating less fibre and taking bowel sedatives to reduce the number of times you go to the toilet. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to have this pattern of change in bowel habit, your GP is likely to advise referral to a routine hospital clinic.
    3. I have a change in my bowel habit that is different from the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: Your change in bowel habit may be caused by something you've eaten or a mild gut infection.
      • Treatment: It is safe to see if you get better just by eating a healthy regular diet.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to have this pattern of change in bowel habit, your GP is likely to advise referral to a routine hospital clinic.
  20. Please describe how your bowel habits have changed:
    (Only answer this question if you answered B to question 18)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: Your constipation is unlikely to have a serious cause, particularly if you don't have any abdominal pain. If you do, go back to the beginning of the checker and click on abdominal pain.
      • Treatment: Try eating more fibre and taking laxatives to make the stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to have constipation, your GP is likely to advise referral to a routine hospital clinic.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: Your change in bowel habit is probably caused by the after-effects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you go to the toilet. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in my bowel habit that is different from the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: Your change in bowel habit may be caused by something you've eaten or a mild gut infection.
      • Treatment: It is safe to see if you get better just by eating a healthy regular diet.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to have this pattern of change in bowel habit, your GP is likely to advise referral to a routine hospital clinic.
  21. Have you had any symptoms of piles? (Only answer this question if you answered C to question 15)
    1. I have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The rectal bleeding is probably from piles, caused by your constipation.
      • Treatment: Try eating a healthy regular diet. Also try cleaning around the anus carefully and use creams and suppositories for your pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed, your GP is likely to advise referral to a routine hospital clinic.
    2. I don't have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the result of something you have eaten or a mild gut infection.
      • Treatment: It is safe to see if you get better just by eating a healthy regular diet.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  22. Have you also had bleeding from your bottom (rectal bleeding) in addition to the change in bowel habit?
    (Only answer this question if you answered B to question 3)
    1. I also have rectal bleeding
    2. I don't have any rectal bleeding
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
  23. How long have you had a change in bowel habit? (Only answer this question if you answered B to question 22)
    1. Less than four weeks
    2. More than four weeks
  24. Please describe how your bowel habits have changed: (Only answer this question if you answered A to question 23)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Cause of your symptoms: Your constipation is unlikely to have a serious cause, particularly if you don't have any abdominal pain. If you do, go back to the beginning of the checker and click on abdominal pain.
      • Treatment: It is safe to see if you get better with simple treatments. Try eating more fibre and taking laxatives to make your stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal and you have no abdominal pain, it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to have constipation, your GP is likely to advise referral to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Cause of your symptoms: Your change in bowel habit is probably caused by the after-effects of a mild gut infection.
      • Treatment: It is safe to try some simple treatments. Try eating less fibre and taking bowel sedatives to reduce the number of times you go to the toilet. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you're over 60 years old, and your change in bowel habit has persisted for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 60, your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in my bowel habit that is different from the other options
      • Cause of your symptoms: Your change in bowel habit may be caused by something you've eaten or a mild gut infection.
      • Treatment: It is safe to see if you get better by eating a healthy regular diet.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  25. Please describe how your bowel habits have changed: (Only answer this question if you answered B to question 23)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Cause of your symptoms: Your constipation is unlikely to have a serious cause, particularly if you don't have any abdominal pain. If you do, go back to the beginning of the checker and click on abdominal pain.
      • Treatment: Try eating more fibre and taking laxatives to make the stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Cause of your symptoms: Your change in bowel habit may be caused by something you've eaten or a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you go to the toilet. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you're over 60 years old, and your change in bowel habit has persisted for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 60, your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in my bowel habit that is different from the other options
      • Cause of your symptoms: Your change in bowel habit may be caused by something you've eaten or a mild gut infection.
      • Treatment: It is safe to see if you get better just by eating a healthy regular diet.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  26. How long have you had rectal bleeding? (Only answer this question if you answered A to question 22)
    1. Less than four weeks
    2. More than four weeks
  27. Please describe how your bowel habit has changed:
    (Only answer this question if you answered A to question 26)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The rectal bleeding is probably from piles, caused by your constipation.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
    3. I have a change in my bowel habit that is different from the other options
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the result of something you have eaten or a mild gut infection.
  28. Please describe how your bowel habits have changed:
    (Only answer this question if you answered B to question 26)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: See your GP. Although your bleeding is probably from piles caused by constipation, it is worth discussing this with your GP.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: See your GP. As you have persistent symptoms it is worth discussing this with your GP.
    3. I have a change in my bowel habit that is different from the other options
      • Advice: See your GP. Although it is likely that your bleeding is caused by piles, it is worth discussing this with your GP.
  29. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 28)
    1. Less than four weeks
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    2. More than four weeks
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
  30. Have you had any symptoms of piles? (Only answer this question if you answered A to question 28 or C to question 28)
    1. I have pile symptoms
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  31. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 27)
    1. Less than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and your change in bowel habit could be the after-effects of a mild gut infection.
      • Treatment: It is safe to try some simple treatments. Try eating less fibre and taking bowel sedatives to reduce the number of times you go to the toilet. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    2. More than four weeks
      • Advice: See your GP. As your symptoms have persisted for more than four weeks it is worth discussing this with your GP.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
  32. Have you had any symptoms of piles? (Only answer this question if you answered A to question 27)
    1. I have pile symptoms
      • Treatment: Try eating more fibre and taking laxatives to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Treatment: Try eating more fibre and taking laxatives to make the stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  33. How long have you had abdominal pain or discomfort? (Only answer this question if you answered C to question 2)
    1. Less than four weeks
    2. More than four weeks
  34. Have you had any decrease in your appetite because of the abdominal pain?
    (Only answer this question if you answered B to question 33)
    1. My appetite has decreased; I feel full soon after eating; and/or I'm eating less because it causes abdominal discomfort
      • Advice: See your GP. Abdominal pain or discomfort provoked every time you eat, feelings of fullness soon after eating, or symptoms that cause you to eat less, always require prompt investigation by your GP.
      • What your GP will do: If you continue to have this pattern of symptoms, it could indicate a partial bowel blockage. If this is the case, your GP will arrange prompt referral to hospital.
    2. My appetite is normal and I generally enjoy eating
  35. Have you also had bleeding from your bottom (rectal bleeding) or a change in bowel habit?
    (Only answer this question if you answered B to question 34)
    1. I have no rectal bleeding and no change in bowel habit
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: It's very unlikely you have anything seriously wrong if your abdominal discomfort or pain doesn't stop any of your activities, particularly eating, working or sleeping. It is likely to be caused by some bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your abdominal pain doesn't get better you may be referred to a routine hospital clinic.
    2. I have rectal bleeding; or I have rectal bleeding with a change in bowel habit
    3. I have a change in bowel habit without rectal bleeding
  36. Have you also had a change in bowel habit?
    (Only answer this question if you answered B to question 35)
    1. I have had no change in bowel habit
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the abdominal pain or discomfort is likely to be the result of bowel spasm.
    2. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
    3. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: Your abdominal discomfort is likely to be caused by bowel spasm, and the bleeding is likely to be from piles and caused by your constipation.
    4. I have a change in bowel habit that is different from the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
  37. Have you had any symptoms of piles? (Only answer this question if you answered A to question 36)
    1. I have pile symptoms
      • Treatment: Try eating more fibre to make your stools softer and easier to pass, and if necessary take antispasmodic tablets for the abdominal discomfort. Try careful cleaning around the anus after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I don't have pile symptoms
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you have had bleeding without pile symptoms for more than six weeks, your GP may advise referral to a hospital clinic within the next two weeks. Otherwise, your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. Even if these were normal it would still be likely that you would be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  38. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 36)
    1. Less than four weeks
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
    2. More than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
  39. Have you had any symptoms of piles?
    (Only answer this question if you answered C to question 36)
    1. I have pile symptoms
      • Treatment: Try eating more fibre to make your stools softer and easier to pass, and if necessary take antispasmodic tablets for the abdominal discomfort. Try careful cleaning around the anus after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I don't have pile symptoms
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  40. Have you had any symptoms of piles?
    (Only answer this question if you answered D to question 36)
    1. I have pile symptoms
      • Treatment: Try eating more fibre to make your stools softer and easier to pass, and if necessary take antispasmodic tablets for the abdominal discomfort. Try careful cleaning around the anus after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I don't have pile symptoms
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  41. How long have you had a change in bowel habit? (Only answer this question if you answered C to question 35)
    1. Less than four weeks
    2. More than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
  42. Please describe how your bowel habits have changed: (Only answer this question if you answered B to question 41)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    3. I have a change in bowel habit that is different to the other options
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
  43. Please describe how your bowel habits have changed:
    (Only answer this question if you answered A to question 41)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    3. I have a change in bowel habit that is different to the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
  44. Have you also had bleeding from your bottom (rectal bleeding) or a change in bowel habit?
    (Only answer this question if you answered A to question 33)
    1. I have no rectal bleeding and no change in bowel habit
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: It's very unlikely you have anything seriously wrong if your abdominal discomfort or pain doesn't stop any of your activities, particularly eating, working or sleeping. It is likely to be caused by some bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your abdominal pain doesn't get better you may be referred to a routine hospital clinic.
    2. I have rectal bleeding; or I have rectal bleeding with a change in bowel habit
    3. I have a change in bowel habit without rectal bleeding
  45. Have you also had a change in your bowel habit?
    (Only answer this question if you answered B to question 44)
    1. I have had no change in bowel habit
    2. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
    3. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
    4. I have a change in bowel habit that is different from the other options
  46. Have you had any symptoms of piles? (Only answer this question if you answered A to question 45)
    1. I have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and if you have no loss of appetite, your abdominal pain or discomfort is probably caused by bowel spasm.
      • Treatment: It’s safe to try some simple treatments, if you haven't tried them before. If you have and they haven't worked, see your GP. Try eating healthy, regular and smaller meals, and, if necessary, take antispasmodic tablets for the abdominal discomfort. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I don't have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and if you have no loss of appetite, your abdominal pain or discomfort is probably caused by bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  47. How long have you had a change in bowel habit?
    (Only answer this question if you answered C to question 44)
    1. Less than four weeks
    2. More than four weeks
  48. Please describe how your bowel habits have changed: (Only answer this question if you answered B to question 47)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    3. I have a change in bowel habit that is different to the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
  49. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 45)
    1. Less than four weeks
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
    2. More than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 40 and have had this pattern of symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 40, your GP will probably examine your tummy and bottom and do a blood test for iron deficiency anaemia. Even if these are normal your GP may still advise referral to a routine hospital clinic.
  50. Have you had any symptoms of piles? (Only answer this question if you answered C to question 45)
    1. I have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and caused by the constipation. If the abdominal pain or discomfort hasn't put you off eating, it is likely to be down to bowel spasm, again the result of the constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I don't have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and caused by the constipation. If the abdominal pain or discomfort hasn't put you off eating, it is likely to be down to bowel spasm, again the result of the constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  51. Have you had any symptoms of piles? (Only answer this question if you answered D to question 45)
    1. I have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: It’s safe to try some simple treatments, if you haven't tried them before. If you have and they haven't worked, see your GP. Try eating healthy, regular and smaller meals, and, if necessary, take antispasmodic tablets for the abdominal discomfort. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I don't have pile symptoms
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  52. Please describe how your bowel habits have changed: (Only answer this question if you answered A to question 47)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating regular, healthy, smaller meals and try taking mild laxatives. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
    3. I have a change in bowel habit that is different to the other options
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't get better you may be referred to a routine hospital clinic.
  53. How long have you had your abdominal pain or discomfort?
    (Only answer this question if you answered C to question 3)
    1. Less than four weeks
    2. More than four weeks
  54. Have you had any decrease in your appetite because of the abdominal pain?
    (Only answer this question if you answered B to question 53)
    1. My appetite has decreased; I feel full soon after eating; and/or I'm eating less because it causes abdominal discomfort
      • Advice: See your GP. Abdominal pain or discomfort provoked every time you eat, feelings of fullness soon after eating, or symptoms that cause you to eat less, always require prompt investigation by your GP.
      • What your GP will do: If you continue to have this pattern of symptoms, it could indicate a partial bowel blockage. If this is the case, your GP will arrange prompt referral to hospital.
    2. My appetite is normal and I generally enjoy eating
  55. Have you also had bleeding from your bottom (rectal bleeding) or a change in bowel habit? (Only answer this question if you answered B to question 54)
    1. I have no rectal bleeding and no change in bowel habit
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal discomfort or pain doesn't stop any of your activities, such as eating, working or sleeping it is probably caused by simple bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your abdominal pain doesn't get better you may be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I have rectal bleeding; or I have rectal bleeding with a change in bowel habit
    3. I have a change in bowel habit without rectal bleeding
  56. How long have you had rectal bleeding? (Only answer this question if you answered B to question 55)
    1. Less than four weeks
    2. More than four weeks
  57. Have you also had a change in bowel habit? (Only answer this question if you answered B to question 56)
    1. I have had no change in bowel habit
      • Advice: See your GP. Although it is likely that your bleeding is caused by piles, it is worth discussing this with your GP.
      • What your GP might do: If you have had bleeding without pile symptoms for more than six weeks, your GP may advise referral to a hospital clinic within the next two weeks. Otherwise, your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. Even if these were normal it would still be likely that you would be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
      • Advice: See your GP. As you have persistent symptoms it is worth discussing this with your GP.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    3. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: See your GP. As your symptoms have persisted for more than four weeks it is worth discussing this with your GP.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your abdominal pain doesn't get better you may be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    4. I have a change in bowel habit that is different from the other options
      • Advice: See your GP. As you have persistent symptoms it is worth discussing this with your GP.
      • What your GP might do: If you have had bleeding without pile symptoms for more than six weeks, your GP may advise referral to a hospital clinic within the next two weeks. Otherwise, your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. Even if these were normal it would still be likely that you would be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  58. Have you also had a change in bowel habit? (Only answer this question if you answered A to question 56)
    1. I have had no change in bowel habit
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and if you have no loss of appetite, your abdominal pain or discomfort is probably caused by bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you have had bleeding without pile symptoms for more than six weeks, your GP may advise referral to a hospital clinic within the next two weeks. Otherwise, your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. Even if these were normal it would still be likely that you would be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: Your abdominal discomfort is likely to be caused by bowel spasm, and the bleeding is likely to be from piles and caused by your constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and the change in bowel habit could be the after-affects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    4. I have a change in bowel habit that is different from the other options
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you have had bleeding without pile symptoms for more than six weeks, your GP may advise referral to a hospital clinic within the next two weeks. Otherwise, your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. Even if these were normal it would still be likely that you would be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  59. How long have you had a change in bowel habit? (Only answer this question if you answered C to question 55)
    1. Less than four weeks
    2. More than four weeks
  60. Please describe how your bowel habits have changed: (Only answer this question if you answered B to question 59)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: See your GP. As your symptoms have persisted for more than four weeks it is worth discussing this with your GP.
      • What your GP might do: If you are over the age of 60, your GP may refer you to a hospital clinic within the next two weeks. If you're under 60 you will probably have an examination of your bottom and tummy and a blood test for iron deficiency anaemia. Even if these are normal it is still likely you will be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in my bowel habit that is different from the other options
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  61. Please describe how your bowel habits have changed:
    (Only answer this question if you answered A to question 59)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, your GP may refer you to a hospital clinic within the next two weeks. If you're under 60 you will probably have an examination of your bottom and tummy and a blood test for iron deficiency anaemia. Even if these are normal it is still likely you will be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in bowel habit that is different to the other options
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  62. Have you also had bleeding from your bottom (rectal bleeding) or a change in bowel habit?
    (Only answer this question if you answered A to question 53)
    1. I have no rectal bleeding and no change in bowel habit
      • Advice: It's safe to wait four more weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal discomfort or pain doesn't stop any of your activities, such as eating, working or sleeping it is probably caused by simple bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these were normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your abdominal pain doesn't get better you may be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I have rectal bleeding; or I have rectal bleeding with a change in bowel habit
    3. I have a change in bowel habit without rectal bleeding
  63. How long have you had rectal bleeding?
    (Only answer this question if you answered B to question 62)
    1. Less than four weeks
    2. More than four weeks
  64. Have you also had a change in bowel habit? (Only answer this question if you answered B to question 63)
    1. I have had no change in bowel habit
    2. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
    3. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
    4. I have a change in bowel habit that is different from the other options
  65. Have you had any symptoms of piles?
    (Only answer this question if you answered A to question 64)
    1. I have pile symptoms
      • Advice: See your GP. Although it is likely that your bleeding is caused by piles, it is worth discussing this with your GP.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: See your GP. Although it is likely that your bleeding is caused by piles, it is worth discussing this with your GP.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  66. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 64)
    1. Less than four weeks
      • Advice: See your GP. As you have persistent rectal bleeding, it is worth discussing this with your GP.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    2. More than four weeks
      • Advice: See your GP. As you have persistent symptoms it is worth discussing this with your GP.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
  67.  Have you had any symptoms of piles?
    (Only answer this question if you answered C to question 64)
    1. I have pile symptoms
      • Advice: See your GP. Although your bleeding is probably from piles caused by constipation, it is worth discussing this with your GP.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: See your GP. Although your bleeding is probably from piles caused by constipation, it is worth discussing this with your GP.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  68. Have you had any symptoms of piles?
    (Only answer this question if you answered D to question 64)
    1. I have pile symptoms
      • Advice: See your GP. Although it is likely that your bleeding is caused by piles, it is worth discussing this with your GP.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: See your GP. Although it is likely that your bleeding is caused by piles, it is worth discussing this with your GP.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  69. Have you also had a change in bowel habit?

    (Only answer this question if you answered A to question 63)
    1. I have had no change in bowel habit
    2. I am going to the toilet to open my bowels more often, my stools are persistently looser and softer, or I have both of these changes
    3. I am going to the toilet less often, I have harder, drier stools, or I have both of these changes
    4. I have a change in bowel habit that is different from the other options
  70. Have you had any symptoms of piles?
    (Only answer this question if you answered A to question 69)
    1. I have pile symptoms
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and if you have no loss of appetite, your abdominal pain or discomfort is probably caused by bowel spasm.
      • Treatment: It’s safe to try some simple treatments, if you haven't tried them before. If you have and they haven't worked, see your GP. Try eating healthy, regular and smaller meals, and, if necessary, take antispasmodic tablets for the abdominal discomfort. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and if you have no loss of appetite, your abdominal pain or discomfort is probably caused by bowel spasm.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  71. How long have you been passing looser, softer stools and/or going to the toilet more frequently to open your bowels? (Only answer this question if you answered B to question 69)
    1. Less than four weeks
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles, and the change in bowel habit could be the after-affects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
    2. More than four weeks
      • Advice: See your GP. Your rectal bleeding could be from piles and your change in bowel habit could be caused by a mild gut infection but it is worth discussing your symptoms further with your GP.
      • What your GP might do: If you've had this pattern of symptoms for six weeks your GP will probably refer you to a hospital clinic within the next two weeks.
  72. Have you had any symptoms of piles?
    (Only answer this question if you answered C to question 69)
    1. I have pile symptoms
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and caused by the constipation. If the abdominal pain or discomfort hasn't put you off eating, it is likely to be down to bowel spasm, again the result of the constipation.
      • Treatment: Try eating more fibre and taking laxatives to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is probably from piles and caused by the constipation. If the abdominal pain or discomfort hasn't put you off eating, it is likely to be down to bowel spasm, again the result of the constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  73. Have you had any symptoms of piles?
    (Only answer this question if you answered D to question 69)
    1. I have pile symptoms
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: It’s safe to try some simple treatments, if you haven't tried them before. If you have and they haven't worked, see your GP. Try eating healthy, regular and smaller meals, and, if necessary, take antispasmodic tablets for the abdominal discomfort. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I don't have pile symptoms
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: The bleeding is likely to be from piles and the change in bowel habit and abdominal problems could be the result of a mild gut infection.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  74. How long have you had a change in your bowel habits?
    (Only answer this question if you answered C to question 62)
    1. Less than four weeks
    2. More than four weeks
  75. Please describe how your bowel habits have changed:
    (Only answer this question if you answered B to question 74)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating regular, healthy, smaller meals and try taking mild laxatives. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: See your GP. As you have persistent symptoms it is worth discussing this with your GP.
      • What your GP might do: If you're over 60 years old, and your change in bowel habit has persisted for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 60, your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in my bowel habit that is different from the other options
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  76. Please describe how your bowel habits have changed:
    (Only answer this question if you answered A to question 74)
    1. I'm going to the toilet less often, I have harder, drier stools, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably the result of bowel spasm caused by constipation.
      • Treatment: Try eating more fibre and taking a laxative to make your stools softer and easier to pass. The abdominal discomfort is likely to be caused by bowel spasm and an antispasmodic tablet might help. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I'm going to the toilet more often to open my bowels, my stools are persistently looser and softer, or I have both of these changes
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm. The change in your bowel habit could be the after-effects of a mild gut infection.
      • Treatment: Try eating less fibre and taking bowel sedatives to reduce the number of times you are going to the toilet. You could also try antispasmodic tablets for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you're over 60 years old, and your change in bowel habit has persisted for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you're under 60, your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    3. I have a change in bowel habit that is different to the other options
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Cause of your symptoms: If your abdominal pain or discomfort doesn't put you off eating, it's probably caused by bowel spasm and your change in bowel habit is likely to be the result of something you have eaten.
      • Treatment: Try eating regular, healthy, smaller meals and try taking an antispasmodic tablet for the abdominal discomfort. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  77. Have you any symptoms of piles? (Only answer this question if you answered B to question 4)
    1. I have symptoms of piles
      • Treatment: Try eating more fibre and taking laxatives to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed, your GP is likely to advise referral to a routine hospital clinic.
    2. I have no symptoms of piles
      • Treatment: Try eating more fibre and taking laxatives to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if you continue to bleed without pile symptoms, your GP is likely to advise referral to a routine hospital clinic.
  78. Have you any symptoms of piles? (Only answer this question if you answered B to question 8 or D to question 8)
    1. I have symptoms of piles
      • Advice: See your GP Your persistent bleeding may be being caused by piles, but it is worth discussing this with your GP as people over 50 are more likely to have easily removable polyps, which, if left, could develop into more serious problems in the future.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I have no symptoms of piles
      • Advice: See your GP. Your persistent rectal bleeding may be the result of piles caused by your other symptoms but it's worth discussing this with your GP, as people over the age of 50 are more likely to have easily removable polyps, which, if left, could develop into more serious problems in the future.
      • What your GP might do: If you are over the age of 60, your GP may refer you to a hospital clinic within the next two weeks. If you're under 60 you will probably have an examination of your bottom and tummy and a blood test for iron deficiency anaemia. Even if these are normal it is still likely you will be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  79. Have you any symptoms of piles? (Only answer this question if you answered B to question 9)
    1. I have symptoms of piles
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Treatment: Try eating more fibre and taking laxatives to make your stools softer and easier to pass. It's normal to strain a little when passing a stool, but too much can cause bleeding. Try cleaning around the anus carefully after passing a stool and, if necessary, use creams and suppositories for the pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I have no symptoms of piles
      • Advice: It's safe to wait for another two weeks to see if your symptoms settle.
      • Treatment: It is safe to see if you get better with simple treatments. Try eating more fibre and taking laxatives to make your stools softer and easier to pass. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
  80. Have you any symptoms of piles? (Only answer this question if you answered C to question 27)
    1. I have no symptoms of piles
      • Treatment: It is safe to see if you get better by eating a healthy regular diet.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: If you are over the age of 60, and continue to have bleeding without pile symptoms for six weeks, your GP may advise referral to a hospital clinic within the next two weeks. If you are under 60 your GP may examine your tummy and bottom and a do a blood test for iron deficiency anaemia. Even if these are normal, you may still be referred to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.
    2. I have symptoms of piles
      • Treatment: Try eating a healthy regular diet. Also try cleaning around the anus carefully and use creams and suppositories for your pile symptoms. A pharmacist can advise on suitable treatments.
      • What now? If you get better, nothing further needs to be done. However, see your GP if your symptoms persist or come back.
      • What your GP might do: Your GP may examine your bottom and tummy and do a blood test for iron deficiency anaemia. If these are normal it would be reasonable for you to try a further period of treat, watch and wait. However, if your symptoms don't settle quickly, your GP may refer you to a routine hospital clinic for a screening technique known as a flexible sigmoidoscopy.

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