Perineal disease and faecal incontinence

Emergency department referrals

All urgent cases must be discussed with the on call Surgical Registrar to obtain appropriate prioritisation and treatment. Contact through:

  • Royal Brisbane and Women's Hospital (07) 3646 8111
  • The Prince Charles Hospital (07) 3139 4000
  • Redcliffe Hospital (07) 3883 7777
  • Caboolture Hospital (07) 5433 8888

Urgent cases accepted via phone must be accompanied with a written referral and a copy faxed immediately to the Central Patient Intake Unit: 1300 364 952.

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Persistent perineal sepsis

Category 2

Appointment within 90 days is desirable

  • Symptomatic obstetric anal sphincter injury (OASIS)
  • Anal fissure not responding to maximal medical treatment after 6 weeks
  • External rectal prolapse
  • Acute testicular pain
  • Uncomplicated fistula-in-ano

Category 3

Appointment within 365 days is desirable

  • Pilonidal disease/sinus
  • Perianal warts
  • Uncomplicated haemorrhoids
  • Anal skin tags and benign peri-anal polyps
  • Faecal incontinence
  • Pruritis ani

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Refer to HealthPathways for assessment and management information if available
  • Local application of cold packs and oral anti-inflammatory medications
  • Patients with haemorrhoids or any other functional disorders should be discouraged from straining excessively or sitting on the toilet for prolonged periods (<5 minutes)
  • Lifestyle modification (e.g., increased physical activity, balanced healthy diet, weight reduction, smoking and alcohol cessation) can be very useful for a wide range of functional bowel and anorectal issues
  • Referral to pelvic floor physiotherapist is very useful for faecal incontinence or bowel evacuatory dysfunction
  • Education around specific techniques for defecation:
    • Positioning: elevated feet
    • Stool modification: use of aperients to achieve soft, but formed, stool
    • Increase water intake (>2L/day) and dietary fibre, including fibre supplementation (e.g., Metamucil, Benefibre, psyllium husk)

Anal fissure

  • In addition to best supportive care (i.e., stool modification, salt baths for symptomatic relief), Glyceryl trinitrate 0.2% ointment (Rectogesic®) TDS for should be prescribed (and used strictly) for six weeks

Pilonidal Sinus

  • Advice on hygiene, sweating activity, activity associated with sitting and buttock friction, depilation treatments (e.g., laser hair removal)

Referral requirements

A referral may be rejected without the following information.

  • Management to date including timeline, medication and lifestyle
  • Details and results/reports of most recent gastrointestinal/perianal investigations or procedures (e.g. imaging, colonoscopy, biopsy/polypectomy results) including letters of correspondence

Additional referral information useful for processing the referral

  • Digital anorectal examination findings


Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary
  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Send referral

Hotline: 1300 364 938

Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs

Metro North Central Patient Intake
Aspley Community Centre
776  Zillmere Road

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