Refer immediately (on the same day) to a specialist for patients presenting with dyspepsia together with significant acute gastrointestinal bleeding NICE NG12.
Consider a very urgent full blood count within 48 hours for unexplained bleeding, bruising, or petechiae, which may indicate serious underlying conditions such as leukaemia NICE NG12.
Refer using a suspected cancer pathway referral for dyspepsia with weight loss in patients aged 55 and over, or with symptoms such as dysphagia, or reflux with weight loss NICE NG12.
Refer using a suspected cancer pathway referral for unexplained anal mass or ulceration, rectal mass, or if there are symptoms suggestive of oesophageal or stomach cancer, such as persistent or significant symptoms NICE NG12.
Consider urgent investigations such as a CT scan within 2 weeks for patients with nausea or vomiting with weight loss in those aged 60 and over, or with upper abdominal pain and weight loss in those aged 55 and over NICE NG12.