
This will depend on taking a thorough history and performing a full examination including a full internal digital rectal examination. This will be followed by insertion of the sigmoidoscope, a plastic telescope of about 20cm length. This is accompanied by inflation of air into the bowel, which can be quite uncomfortable. The examination is completed by proctoscopy, a shorter telescope to look right at the anal margin.
If the cause of the bleeding has not been identified, it may be necessary to examine the bowel further by either colonoscopy or a barium enema X-ray. It should be noted, however, that barium enema reports are NOT definitive and if symptoms persist, further investigation is required.