Criteria for referral to public hospital service

• Unexplained rectal bleeding where a differential diagnosis has been excluded
• Rectal bleeding with recent change in bowel habits, unintended weight loss (> 5 percent of body weight in previous 6 months) or abdominal or rectal mass
• Rectal bleeding with iron deficiency that persists despite correction of potential causative factors or rectal bleeding that persists despite appropriate treatment for more than six weeks.

Information to be included in the referral

Information that must be provided

• Findings on physical examination
• Onset, characteristics and duration of symptoms (including description of rectal bleeding) and if the bleeding persists despite appropriate treatment (e.g. dietary fibre and fluid intake, aperients) for more than six weeks
• Details of previous medical management including the course of treatment(s) and outcome of treatment(s)
• If rectal bleeding with iron deficiency
  • full blood examination
  • iron studies or serum ferritin.

Provide if available

• Previous colonoscopy results
• Recent faecal occult blood test results 
• Details of relevant family history of gastrointestinal or colorectal cancers.

Additional comments

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

Note: there are also statewide referral criteria for direct referrals for Positive faecal occult blood test (FOBT) - diagnostic colonoscopy that are accepted by some public health services

Note: there are also gastroenterology statewide referral criteria for Rectal bleeding and Persistent iron deficiency.

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

Rectal bleeding with a known cause where serious colorectal pathology has been excluded and the symptoms remain unchanged, are occasional, or have resolved.