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Colorectal bowel diseases

Find assessment and management information at SpotOnHealth HealthPathways under:

Useful management information

  • Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)
  • Correct iron deficiency and anaemia if possible
  • Routine follow-up of patients on treatments for IBD
  • Change in symptoms should initiate reassessment of previous results

Minimum referral criteria (Does your patient meet the minimum criteria?)

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark “urgent” on your referral

  • Diagnosed malignancies
  • Palpable or visible anorectal mass
  • IBD
  • Recent significant unexplained weight loss
  • GI obstructive symptoms
  • Colovesical or colovaginal fistula
  • FOBT positive
  • Rectal bleeding with any of the following concerning features
    • Dark blood coating or mixed with stool
    • Weight loss, ≥5% of body weight in previous 6 months
    • Abdominal / rectal mass
    • Iron deficiency in males and postmenopausal women or unexplained iron deficiency in premenopausal women
    • Patient and family history of bowel cancer (1st degree relative <55 years old)
Category 2
(appointment within 90 calendar days)
  • Chronic ongoing colorectal problems
  • Recurrent diarrhoea
  • Diverticular disease for evaluation
  • Rectal bleeding without any concerning features
Category 3
(appointment within 365 calendar days)
  • Pruritus ani

If your patient does not meet the minimum referral criteria

  • Assessment and management information can be found on a range of conditions at SpotOnHealth HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information (To be included in all referrals)

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

 

Essential referral information for Colorectal bowel diseases referrals (Referral will be returned without this)

  • Specific family history of gastrointestinal malignancy, polyposis or IBD
  • Previous gastroenterologist investigations and results (date, report and histology results) e.g. last 2-3 clinic letters
  • History of weight loss and/or ascites
  • History of bowel function:
    • altered bowel habit
    • rectal tenesmus
    • incomplete rectal emptying
    • PR blood, pus or mucus
    • flatus
    • mass
  • Comorbid conditions and other risk factors (if applicable)
  • FBC, ELFT, U&E, CRP, iron studies
  • CEA results (if diagnosis of cancer is suspected)

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional referral information for Colorectal bowel diseases referrals

  • Relevant imaging report/s
  • CT of chest, abdomen and pelvis results
  • Virtual CT report
  • Any positive DRE findings and perianal conditions
  • Previous colonoscopy and polypectomy results
  • Biopsy results 
  • FOBT results

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 18 March 2022