Diarrhoea
Outpatients | GastroenterologyThis condition is treated in the Gastroenterology clinic.
Pre-referral work-up
History
All referrals should comply to referral standards and include in particular:
- Patient and family history of gastrointestinal cancer
- Previous gastrointestinal investigations and results (date and report)
Tests
Pathology:
- LFT
- FBC
- U&E
- TSH
- iron studies
- Coeliac disease serology (where indicated / performed)
- Stool PCR for pathogens and parasites.
- Stool calprotectin (where suspicion of inflammatory bowel disease)
Imaging:
Any relevant
Investigations:
Nil
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 HealthPathways Tasmania website.
Clinic appointments
🚩 Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
Emergency
🚩 Potentially life-threatening symptoms suggestive of:
- acute upper GI tract bleeding
- acute severe lower GI tract bleeding
- oesophageal foreign bodies/food bolus
- bowel obstruction
- abdominal sepsis
- Acute Severe Colitis - see note
🚩 Severe vomiting and/or diarrhoea with dehydration
🚩 Acute/fulminant liver failure (to be referred to a centre with dedicated hepatology services
🚩 Biliary sepsis (to be referred to a centre with ERCP service)
Note- Acute severe colitis as defined by the Truelove and Witts criteria - all patients with greater than or equal to 6 bloody bowel motions per 24 hours plus at least one of the following:
- temperature at presentation of over 37.8°C,
- pulse rate at presentation of over 90 bpm,
- haemoglobin at presentation of under 105 gm/l, CRP over 30mg/dl at presentation (or ESR over 30 mm/hr)
If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.
Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.
Urgent (Category 1)
Diarrhoea over 6 weeks that is affecting activities of daily living and with any of the following concerning features select those that apply:
- bloody or nocturnal diarrhoea
- weight loss, greater than or equal to5% of body weight in previous 6 months
- persistent abdominal pain
- iron deficiency in males and postmenopausal women or unexplained iron deficiency in premenopausal women
- patient and/or family history of bowel cancer or inflammatory bowel disease
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 (Category 2)
Diarrhoea over 6 weeks without concerning features (as above)
Availability
North
Launceston General Hospital
Level 3 - Specialist Clinics
Phone: 1300 977 694
Fax: 03 6777 5227
North West
All North West referrals are managed via Mersey Community Hospital
Phone: 03 6478 5222
Fax: 03 6441 5942
South
Wellington Clinics (Level 10)
Phone: 03 6166 0000
Fax: 03 6234 3982