Direct to an emergency department for:

  • Suspected large bowel obstruction
  • Faecal impaction that has not responded to adequate medical management.

Criteria for referral to public hospital specialist clinic services

  • Constipation in patients with a duration of more than 6 weeks but less than 12 months, with any of the following:
    • > 40 years of age
    • rectal bleeding
    • positive faecal occult blood test
    • weight loss (≥ 5% of body weight in previous 6 months)
    • abdominal or rectal mass
    • iron deficiency that persists despite correction of causative factors
    • patient or family history of bowel cancer (first degree relative < 55 years).

Information to be included in the referral

Information that must be provided

  • Onset, characteristics and duration of constipation and sentinel findings
  • Current and previous colonoscopy results
  • Full blood examination
  • Iron studies.

Provide if available

  • Current and previous histology results
  • Details of any previous gastroenterology assessments or opinions
  • Faecal occult blood test
  • Thyroid stimulating hormone levels.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

As part of the referral assessment, patients may be triaged to colonoscopy prior to the appointment at a specialist clinic.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

  • Patients with more than 12 months of symptoms, with no sentinel findings, who have not had an adequate trial of treatment.