Diarrhoea

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Severe persistent diarrhoea with dehydration
    • Acute Severe Colitis*

    *Acute severe colitis as defined by the Truelove and Witts criteria – all patients with ≥ 6 bloody bowel motions per 24 hours plus at least one of the following:

    • Temperature at presentation of > 37.8°C,
    • Pulse rate at presentation of > 90 bpm,
    • Haemoglobin at presentation of < 105 g/L, CRP >30mg/dl at presentation (or ESR > 30 mm/hr)
    • Refer to HealthPathways for assessment and management recommendations.
    • Consider referral to a dietitian with knowledge and experience in managing gastrointestinal issue

    Note: If a patient who has been fully investigated 2 years prior to referral. Then the referrer and the receiving clinician will need to exercise clinical decision making in triaging and or value in repeat endoscopy / colonoscopy procedures

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Diarrhoea > 6 weeks that is with any of the following concerning features :
    • ≥5% unintentional weight loss (6 months)
    • Gastrointestinal bleeding
    • Iron deficiency in males and non-menstruating females or unexplained iron deficiency in menstruating females
    • Persistent vomiting
    • Abnormal imaging or mass
    • Bloody or nocturnal diarrhoea
    • Persistent unexplained abdominal pain
    • Patient history of oesophageal, gastric or colon cancer, IBD or Barretts
    • Known colonic polyp(s) overdue for surveillance
Category 2
(appointment within 90 calendar days)
  • Diarrhoea > 6 weeks without concerning features (as defined above)

Note: Referrals for conditions such as diarrhoea should be directed through the most clinically appropriate pathway. This may include a complementary care pathway, a Dietitian First gastroenterology clinic pathway. The triage process should be guided by the patient’s predominant clinical features, the suspected underlying cause, and the investigations or interventions most likely to be required.

In some Hospital and Health Services (HHSs), patients may be considered for an initial assessment by a Dietitian, either before or instead of being referred to Gastroenterology. This approach supports appropriate and timely referrals to the most suitable pathway, ensuring patients receive the care that best addresses their specific needs.
Category 3
(appointment within 365 calendar days)
  • No category 3 criteria

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • 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

2. Essential referral information Referral will be returned without this

  • Patient and family history of gastrointestinal cancer
  • ELFT, FBC, TSH, iron studies results
  • Coeliac disease serology results
  • iFOBT/FIT for all patients aged ≥40 years and a faecal calprotectin for patients under 50 years (who meet MBS criteria for testing), particularly if there has been no endoscopy or colonoscopy in the past two years
  • Symptom duration (>6 weeks) or negative stool infective screen (Multiplex PCR, C Diff)
  • Previous gastrointestinal investigations and results (date and report)

3. Additional referral information Useful for processing the referral

  • Recent travel history
  • CRP, faecal calprotectin, if inflammatory bowel disease is suspected
  • Clostridium difficile toxin (if recent antibiotics)
  • Relevant imaging reports

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    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
    • 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
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    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

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    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.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 29 September 2026

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