Direct to an emergency department for:

  • Potentially life-threatening symptoms suggestive of acute severe lower gastrointestinal tract bleeding.

Criteria for referral to public hospital specialist clinic services

  • Rectal bleeding in patients with any of the following:
    • 40 years or older 
    • unintended weight loss (≥ 5% of body weight in previous 6 months)
    • abdominal or rectal mass
    • recent change in bowel habits
    • iron deficiency that persists despite correction of potential 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 symptoms
  • Full blood examination
  • Urea and electrolytes
  • Iron studies
  • Previous and current gastrointestinal investigations and results
  • Patient age
  • Details of relevant family history of gastrointestinal or colorectal cancers.

Provide if available

  • Current and previous colonoscopy results.

Additional comments

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

Referrals for colonoscopy requested for a positive faecal occult blood test should be made using Victoria's colonoscopy referral information form.

Referrals for severe haemorrhoids should be directed to colorectal service provided by the health service.

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

  • Persistent but unchanged symptoms previously investigated
  • If the patient has had a full colonoscopy in the last 2 years for the same symptoms
  • Untreated anal fissures
  • Bleeding is known to be coming from haemorrhoids.