​​​​​​​​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:

  • suspected or known inflammatory bowel disease with severe abdominal pain and/or bloody diarrhoea, and any of the following features:
    • fever
    • haemodynamic compromise
    • suspected megacolon
    • suspected bowel perforation
    • bowel obstruction
    • abscess (abdominal or perianal)
    • haemoglobin < 90 g/L.

When public outpatient services are not routinely provided

Bloody diarrhoea in the presence of bacterial infection found on stool multiplex PCR.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Suspected or known inflammatory bowel disease where chronic diarrhoea (bloody or non-bloody) or other symptoms > 4 weeks with elevated faecal calprotectin (> 250 mcg/g), and any of the following critical features are present:
    • new progressive gastrointestinal symptoms (for example, abdominal pain, vomiting)
    • faltering growth (weight loss of ≥ 2 weight centiles)
    • perianal pain or fistulae suspected
    • laboratory critical feature:
      • anaemia
      • low albumin
      • elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
      • iron deficiency
      • holotranscobalamin (active vitamin B12) deficiency
    • abnormal imaging suggesting inflammatory bowel disease.

Note: faecal calprotectin levels can be elevated in healthy, pre-school aged children and should be interpreted with caution.

Category 2
Recommended to be seen within 90 calendar days.
  • Suspected inflammatory bowel disease where chronic diarrhoea (non-bloody) or other symptoms > 6 weeks with elevated faecal calprotectin (> 100 mcg/g), and none of the above critical features are present.
  • Known inflammatory bowel disease with a flare of symptoms, and none of the above critical factors are present.
Category 3
Recommended to be seen within 365 calendar days.		Known inflammatory bowel disease for routine follow-up.

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:
    • ‘Blue Book’, growth charts or any recent growth measurements
    • stool multiplex PCR negative and Clostridium difficile toxin
    • faecal calprotectin result (in children aged > 4 years)
    • full blood count (FBC)
    • liver function test result
    • electrolytes, urea and creatinine (EUC)
    • iron studies
    • holotranscobalamin (active vitamin B12)
    • c-reactive protein (CRP)
    • relevant imaging reports
    • current and previous colonoscopy results.

If available

  • Personal or family history of inflammatory bowel disease.
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ and/or among a vulnerable, disadvantaged or priority population
  • 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.



 

Current as at: Thursday 14 November 2024
Contact page owner: System Purchasing