Established Inflammatory Bowel Disease (IBD)

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and include in particular:

History:

  • Crohn's
  • Ulcerative colitis
  • Indeterminate colitis
  • Site: proctitis, left colon, pancolitis, small bowel
  • Details of any previous endoscopies (date, result)
  • Complications e.g. fistula
  • Extra intestinal manifestations e.g. arthritis, iritis, erythema nodosum

Tests

Initial work up:

  • FBE
  • ESR and CRP
  • Faecal specimen for M,C&S
  • Iron studies

Interim/GP management

To refer a patient with this condition, please see the Gastroenterology clinic page for the full referral process and templates.

For more information please see the Tasmanian Health Pathways website.

Urgent / category 1

When patient presents with any of the following, contact Gastroenterology Registrar via switch 6166 8308

  • >6 loose bowel actions per day
  • Urgency
  • PR bleeding
  • Significant abdominal pain
  • Significant weight loss
  • Anaemia
  • Previously severe disease

Semi-urgent / category 2

  • 4 – 6 loose bowel actions per day
  • Occasional PR blood
  • Mild abdominal pain
  • Recurrent symptoms on reducing Steroids
  • Patients known to the IBD Clinic

Routine / category 3

Maintenance:

At least 3 monthly review

  • If taking azathioprine, 6MP, MTX,  infliximab

Patients in remission

  • Colonoscopy screening for colorectal cancer

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

GESA Guideline:Inflammatory Bowel Disease (2013)

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