Diarrhoea

From April – August 2022, the Department will contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form. This forms part of a routine audit to ensure patient details are up to date. If you receive this SMS, please update your details.

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

  • Duration of symptoms
  • Pattern and severity of symptoms especially nocturnal symptoms
  • Blood loss, pain, bloating
  • Systemic symptoms
  • Overseas travel
  • Current and past medications especially failed treatments
  • Family history of Inflammatory Bowel disease

Tests

Initial work up:

 

  • Acute persistent diarrhoea (<6 weeks) or Chronic Diarrhoea (>6 weeks):
    • Stools M,C&S, parasites
    • Consider Clostridium difficile toxin (previous antibiotics)
    • FBE and ESR
    • CRP
    • TFTs
    • Folate and B12
    • Iron studies and Ferritin
    • U&E
    • LFT

Note:

  • Non-colonic symptoms suggestive of inflammatory bowel disease e.g.
    • Uveitis
    • Synovitis
    • Erythema nodosum
    • Anal fissure
    • Family history of inflammatory bowel disease

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

Recommended pre-referral treatment

Lifestyle Changes: Dietary review

Medical Management:

  • Consider constipation with overflow
  • Consider faecal incontinence
  • Consider trial of anti-diarrhoeals – monitor as may be contraindicated if idiopathic IBD

For more information please see the Tasmanian Health Pathways website.

Emergency

Acute severe diarrhoea or bloody diarrhoea

Please contact Emergency Department Medical Officer in Charge via RHH switchboard (03) 6166 8308

Semi-urgent / category 2

Less severe acute diarrhoea or chronic diarrhoea

Clinically suspected inflammatory bowel disease

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

We will endeavour to see these patients within four weeks

Urgent referrals should be accompanied by a phone call to the clinic and the relevant doctor for urgent assessment, or patient should be directed immediately to the Emergency Department.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment