Colorectal Bowel Disease
Adult

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Emergency Referrals

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 referral criteria?

Category 1 (appointment within 30 calendar days)	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 as articulated in category 1
Category 3 (appointment within 365 calendar days)	Pruritus ani
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

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), 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

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

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 (if relevant):
- altered bowel habit
- rectal tenesmus
- incomplete rectal emptying
- PR blood, pus or mucus
- flatus
- mass
Co-morbid conditions and other risk factors
FBC
ELFT
U&E
CEA results (if diagnosis of cancer suspected)

Additional Referral Information

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

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Health Service District

Internal Referrals

Colorectal Surgery (E-Blueslips)

Fax

(07) 5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Gregory Nolan

Medical Director General & Acute Surgery

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Colorectal Bowel Disease Adult