Constipation and Fluctuating Bowel Habits (Inc Suspected IBS)
North South North West Statewide
All referrals should comply to referral standards and include in particular:
- Duration of symptoms
- Pattern and severity of symptoms especially nocturnal symptoms
- Past history especially of bowel or pelvic surgery
- Description of bowel habits including blood loss, pain
- Medications especially use of opioids
Initial work up:
- ESR or CRP
- Folate, B12
- Iron studies
- Creatinine and electrolytes
- Plain abdominal x-ray
- Stools M,C&S, parasites in patients with an element of diarrhoea
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: Increase dietary fibre if lacking and fluid intake.
- Bulk forming laxatives e.g. Metamucil – must maintain adequate fluid intake and will likely take several days for effect
- Stimulant laxatives e.g. coloxyl with senna or bisacodyl – increase intestinal mobility but not suitable for intestinal obstruction
- Osmotic laxatives e.g. macrogol, lactulose – increase the water in the large bowel but not suitable for intestinal obstruction
- Consider pelvic floor dysfunction and pelvic floor physiotherapist management
For more information please see the Tasmanian Health Pathways website.
Suspected bowel obstruction (vomiting and distension with constipation)
Please contact Emergency Department Medical Officer in Charge viaRHH Switchboard (03) 6166 8308
Urgent / category 1
When combined with any of the following alarm symptoms:
Progressive unintentional weight loss
Proven iron deficiency anaemia
Semi-urgent / category 2
Change in bowel function in recent months
Routine / category 3
Long-standing bowel disturbance or suspected Irritable Bowel Syndrome (IBS) without alarm symptoms
Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
GESA Guideline: Irritable Bowel Syndrome (2006)
Proceed to Emergency Department (ED).
LGH ED Reception – Phone: (03) 6777 6405 Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120 Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100 Fax: (03) 6173 0489
Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.
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.
We will endeavour to see these patients within 12 weeks
Next available appointment