​​​​Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • acute severe colitis (for example, Crohn’s disease, ulcerative colitis or infectious) > 6 bloody bowel stools per 24 hours with any of the following:
    • temperature > 37.8°C
    • pulse rate > 90 bpm
    • haemoglobin < 105 g/L
    • severe abdominal pain
    • suspected abscess, perforation or megacolon
  • acute surgical syndrome suspected by symptoms of shock, sepsis or severe abdominal pain with signs suggestive of acute abdomen or jaundice.

When public outpatient services are not routinely provided

  • Second opinions for conditions already seen by the same specialty
  • Suspected cholelithiasis or cholecystitis: referral to upper gastrointestinal surgery may be indicated.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days
  • Persistent or recurrent abdominal pain > 6 weeks with any of the following concerning features:
    • ≥ 5% unexplained weight loss in past 1 month or
      ≥ 10% unexplained weight loss in past 6 months
    • iron deficiency or other abnormal blood tests (haemoglobin, C-reactive protein, liver function test)
    • abdominal mass on examination
    • abnormal imaging (CT or ultrasound) (e.g. luminal pathology or evidence of biliary obstruction (choledocholithiasis))
    • nocturnal symptoms disturbing sleep
    • positive Faecal Occult Blood Test (FOBT)
    • positive Faecal Immunochemical Test (FIT)
    • suspected Familial Mediterranean Fever (FMF) disorder
    • diarrhoea and any critical factor listed in the Inflammatory bowel disease or irritable bowel syndrome (suspected or known) criteria.
Category 2
Recommended to be seen within 90 calendar days

Persistent or recurrent abdominal pain for > 6 weeks without any of the concerning features listed above.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • a history of past gastrointestinal (GI) cancer, abdominal surgery
    • if patient is taking non-steroidal anti-inflammatory drugs (NSAIDs), opioids, anti-depressants, selective serotonin reuptake inhibitors (SSRIs), anticoagulants and/or antiplatelets)
    • examination findings (body mass index, abdominal and digital rectal examination)
    • full blood count
    • iron studies
    • Faecal Occult Blood Test (FOBT) and/or faecal calprotectin result (if lower GI symptoms causes are under consideration)
    • relevant imaging (CT or ultrasound) report.

If available

  • Family history of GI disease in 1st degree relative – irritable bowel syndrome (IBS), cancer, polyp, inflammatory bowel disease (IBD).
  • Smoking status.
  • Drug and alcohol consumption.
  • Previous endoscopic procedures (date, report and histology).
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ or among a vulnerable, disadvantaged or priority population.
  • If the patient is willing to have surgery (where clinically relevant).
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.
  • If the patient requires an interpreter (if so, list preferred language).

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

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Current as at: Sunday 12 May 2024
Contact page owner: System Purchasing