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Seek immediate medical attention (attend A&E or call 999) if blood in stool is accompanied by: Large volumes of bright red blood or continuous bleeding Dizziness, fainting, or signs of significant blood loss Severe abdominal pain or rigidity Vomiting blood or coffee-ground material Black, tarry stools with a foul odour (melaena), suggesting upper gastrointestinal bleeding Rapid heart rate, pallor, or confusion Contact your GP promptly (within 24-48 hours) if you notice: Small amounts of bright red blood on toilet paper or coating the stool Persistent change in bowel habits lasting more than three weeks Unexplained weight loss Persistent abdominal pain or bloating Blood mixed throughout the stool Recurrent episodes of rectal bleeding According to NICE guidance (NG12), patients aged 50 and over with unexplained rectal bleeding should be referred via a suspected cancer pathway (two-week wait) to exclude colorectal cancer

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