This questionnaire does not diagnose anything
It measures how severe and how troublesome your symptoms are right now. It cannot tell you what is causing them, it cannot tell you whether you have haemorrhoids, and it cannot decide whether embolisation or any other treatment is right for you. Only a consultation, an examination and the appropriate tests can do that.
If this is urgent, do not use this page
Heavy or continuous rectal bleeding, black tarry stools, dizziness or fainting need urgent assessment — go to your nearest emergency department or call 000. Rectal bleeding should never be assumed to be haemorrhoids: any change in bowel habit, unexplained weight loss, or bleeding in someone over 45 or with a family history of bowel cancer needs to be assessed by a doctor, usually with a colonoscopy.
This page provides no emergency or urgent clinical assessment, and nobody monitors it outside consulting hours.
What this score measures
Four areas: how often you bleed (0–2), how much you bleed (0–2), whether the bleeding has affected your iron levels or blood count (0–3), and how much discomfort the haemorrhoids cause you (0–2).
The four are added to give a total from 0 to 9. A higher score means a greater burden from haemorrhoidal bleeding. In the study that validated the score, nobody scoring 3 or below was advised to have surgery, while about three-quarters of those scoring 7 or more were.
Discomfort is rated on a 0 to 10 scale and then converted: 0–3 counts as little or no discomfort, 4–6 as moderate, and 7–10 as frank or permanent discomfort.
Scoring follows Table 1 of Fathallah N et al., “Proposal for a New Score: Haemorrhoidal Bleeding Score”, Annals of Coloproctology 2021;37(5):311–317. In that study the score was validated in 100 consecutive patients, agreement between two proctologists was near-perfect (weighted kappa 0.98), no patient scoring 3 or below had an indication for surgery, and a score above 5 best separated those offered surgery from those managed medically. The same score is used in the published haemorrhoidal embolisation series, where it is sometimes called the French or Paris bleeding score. One difference to note: in that study a specialist completed the score after interviewing the patient, using blood test results for the anaemia question. Here you are answering it yourself, so treat the iron and anaemia question as your best understanding and bring it to your doctor.
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Your HBS
Your score helps describe the severity and impact of your current symptoms. It does not by itself diagnose the cause of the symptoms or determine whether embolisation is appropriate.
What it does not tell you:
- What is causing your symptoms — several different conditions produce the same score.
- Whether you are suitable for embolisation, which depends on imaging, examination and your own preferences.
- Anything about how your symptoms will change without treatment.
Take this score to your GP or specialist. It is genuinely useful as a starting point for that conversation — and as a baseline to compare against later.
Get in touch
If your HBS is 4 or above, you may want some advice on what your options are. You can share this result with Tarr Radiology and we will come back to you with an answer to whatever you would like to ask — there is no obligation to book anything.
Your score is in the lower range, so there may be nothing that needs doing right now. If your symptoms are still bothering you, or you would simply like to talk it through, you are very welcome to get in touch.
Privacy
Anonymous calculator. This page works out your score inside your own web browser. Your answers are not sent to Tarr Radiology, and they are not stored on any server, unless you choose to fill in the “Get in touch” section and press send. We do not ask for your date of birth, address, Medicare number or referring doctor here.
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We measure anonymous usage of this page — how many people start and finish the questionnaire, and how long it takes. Your answers and your score are never included in that measurement and are never sent to analytics or advertising services.
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Common questions
What is the Haemorrhoidal Bleeding Score?
It is a short score, from 0 to 9, that combines how often you bleed, where you see the blood, whether your iron or blood count has been affected, and how much discomfort you have. It was published in Annals of Coloproctology in 2021 by a Paris proctology group and validated in 100 consecutive patients, with near-perfect agreement between two specialists scoring the same patients. It is the measure used in the published haemorrhoidal embolisation series, where you may see it called the French or Paris bleeding score.
Why does the discomfort question use a 0 to 10 scale?
Because that is how the score was designed. You rate your discomfort from 0 to 10, and the score converts it: 0 to 3 counts as little or no discomfort, 4 to 6 as moderate, and 7 to 10 as frank or permanent discomfort. Doing the conversion for you avoids the guesswork of choosing a category.
The anaemia question mentions iron deficiency — how would I know?
From a blood test. In the original score, iron deficiency means a ferritin below 30, and anaemia means a haemoglobin below 130 g/L in men or 120 g/L in women. If you have not had these checked recently, answer as best you can and bring the question to your GP — a full blood count and iron studies are part of any proper assessment of rectal bleeding.
Could my bleeding be something other than haemorrhoids?
Yes, and this is important. Bowel cancer, polyps, inflammatory bowel disease and anal fissures can all cause rectal bleeding. No score can distinguish between them. Rectal bleeding needs a doctor's assessment, and often a colonoscopy, before it is put down to haemorrhoids.
What is haemorrhoidal artery embolisation?
It is a keyhole procedure performed through a small puncture, usually in the wrist or groin, that reduces the arterial supply to the haemorrhoidal cushions. It is aimed particularly at bleeding, is done without a general anaesthetic in most cases, and avoids wounds in the anal canal. It may reduce or delay the need for surgery in suitable patients.
Does a low score mean I do not need to be seen?
No. A low score means the bleeding is not currently causing a large burden. It says nothing about the cause. If you are bleeding at all and have not been assessed, see your GP.
Read more
Medically reviewed by Dr Gregory Tarr, MB ChB, PhD, FRANZCR, EBIR
Reviewed 25 July 2026 · next review due July 2027 · instrument: Haemorrhoidal Bleeding Score
Questionnaire wording, scoring and interpretation clinically approved by Dr Gregory Tarr on 25 July 2026. Items and point values verified against the source publication on 25 July 2026.
This page is general information for Australian patients and their doctors. It is not a substitute for individual medical advice.