​​​​​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 symptoms suggestive of severe flare of known inflammatory bowel disease accompanied by fever, haemodynamic compromise, significant abdominal pain, suspected megacolon, perforation, bowel obstruction and/or abscess and unable to be controlled in the community
  • Suspected or known inflammatory bowel disease with concern for severe or complicated colitis (perforation, toxic mega colon, abscess, bowel obstruction) indicated by:
    • Fever
    • Tachycardia
    • Hypotension
    • Significant abdominal pain/peritonism
    • Abscess (abdominal or perianal)
    • Acute severe colitis: patients with > 6 bloody bowel motions per 24 hours plus at least one of the following:
      • Temperature > 37.8°C
      • Pulse rate > 90 bpm
      • Haemoglobin < 105 gm/L
      • Raised inflammatory markers (erythrocyte sedimentation rate (ESR) > 30 mm/hr or C-reactive protein (CRP) > 30 mg/L).
      ​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Known inflammatory bowel disease where infectious diarrhoea is excluded (by stool M C/S, ova cysts parasites, and Clostridioides difficile toxin) and any of the following are present:
    • elevated faecal calprotectin (> 100 micrograms/g)
    • new progressive, or warning gastrointestinal symptoms (e.g. abdominal pain, vomiting)
    • critical factor:
      • anaemia
      • low albumin
      • elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
      • iron deficiency
      • > 5% unexplained weight loss in past 1 month or > 10% unexplained weight loss in past 6 months
      • pregnancy
    • new, abnormal imaging
    • perianal pain or fistulae suspected.
  • Suspected inflammatory bowel disease where chronic diarrhoea or other suspicious symptoms > 6 weeks with elevated faecal calprotectin (> 100 micrograms/g), and any of the following are present:
    • new progressive, or warning gastrointestinal symptoms (e.g. abdominal pain, vomiting)
    • laboratory critical factor:
      • anaemia
      • low albumin
      • elevated ESR/CRP
      • iron deficiency
    • > 5% unexplained weight loss in past 1 month
    • > 10% unexplained weight loss in past 6 months
    • abnormal imaging suggesting inflammatory bowel disease.
Category 2
Recommended to be seen within 90 calendar days.
  • Known inflammatory bowel disease and none of the above critical factors but flare of symptoms.
  • Suspected inflammatory bowel disease where chronic diarrhoea or other suspicious symptoms > 6 weeks with elevated faecal calprotectin (> 100 micrograms/g), and none of the above critical factors or symptoms.
Category 3
Recommended to be seen within 365 calendar days.
  • Longstanding bowel symptoms suggestive of irritable bowel syndrome with none of the above critical factors or laboratory/imaging changes.
  • Lower gastrointestinal symptoms (e.g. suspected pancreatic exocrine insufficiency, suspected cholangitis colitis, faecal incontinence) and seeking specialist advice.

Information to include within a referral

Required

  • Stool M C/S, ova cysts parasites and Clostridioides difficile toxin (Category 1 referrals only).
  • Molecular testing of stool for infection.
  • Personal or family history of inflammatory bowel disease.
  • Full blood count.
  • Faecal calprotectin result.
  • Liver function test result.
  • Electrolytes, urea and creatinine (EUC).
  • Iron studies.
  • C-reactive protein (CRP).
  • Relevant imaging reports.
  • Current and previous colonoscopy results.
  • Smoking history.
  • Patient health summary (including relevant medical history and medications).

If available

  • 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.

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.​​​

​Contact us

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Current as at: Wednesday 14 February 2024
Contact page owner: System Purchasing