Diarrhoea

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). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6426 5115
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6430 6691
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6222 8919

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