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Colorectal bowel diseases

Find assessment and management information at Brisbane South HealthPathways under:

Useful management information

  • Refer to HealthPathways or local guidelines
  • Digital rectal examination (to exclude malignancy) should be performed for all patients with symptoms of colorectal cancer or other perianal pathologies
  • Lifestyle modification (increased physical activity, balanced healthy diet, weight reduction, smoking and alcohol cessation) can be very useful for a wide range of functional bowel and anorectal issues.
  • Correction of  iron deficiency and anaemia as soon as possible is paramount
  • 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 or abdominal mass
  • Recent significant unexplained weight loss
  • GI obstructive symptoms or stricture
  • Colovesical or colovaginal fistula
  • FOBT positive
  • Rectal bleeding with any concerning features (including those listed below)
    • Dark blood coating or mixed with stool
    • Iron deficiency 
    • Tenesmus
Category 2
(appointment within 90 calendar days)
  • Chronic ongoing colorectal problems
  • Recurrent diarrhoea
  • Diverticular disease for evaluation
  • Rectal bleeding without  concerning features (see category 1)
  • Personal or family history of bowel cancer requiring screening or surveillance
  •  Inflammatory bowel disease without complication
Category 3
(appointment within 365 calendar days)
  • Chronic constipation

If your patient does not meet the minimum referral criteria

  • Assessment and management information can be found on a range of conditions at Brisbane South 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)

  • History of presenting complaint (including any concerning features listed in Cat 1)
  • Co-morbid conditions and risk factors for colorectal disease
  • Family history of polyposis or inherited colorectal cancer syndromes, gastrointestinal malignancy or inflammatory bowel disease
  • Details and results/reports of most recent gastrointestinal investigations or procedures (e.g. imaging, colonoscopy, biopsy/polypectomy results) including letters of correspondence
  • Blood tests (e.g., FBC, E/LFT, U&E, CRP, Iron studies) if performed
  • CEA result (if colorectal cancer 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

  • Digital anorectal examination findings
  • 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 December 2023