Chronic diarrhoea and/or persistent vomiting

Emergency department referrals

All urgent cases must be discussed with the on-call Registrar to obtain appropriate prioritisation and treatment.

Contact through:

  • Caboolture Hospital (07) 5433 8888
  • Redcliffe Hospital (07) 3883 7777
  • Royal Brisbane and Women's Hospital (07) 3646 8111

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.

If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • Vomiting or diarrhoea with weight loss in an infant <1 year
  • Suspected pyloric stenosis
  • Bile stained vomiting
  • Acute onset abdominal distention
  • Weight loss with cardiovascular instability, e.g. postural heart rate changes
  • New onset of blood in diarrhoea or vomitus

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

  • Infants under 1 year
  • Significant weight loss at any age/failure to gain weight
  • Vomiting during sleep
  • Bloody diarrhoea
  • Eating disorder suspected
  • A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service

Category 2

Appointment within 90 days is desirable

  • Most other referrals with chronic diarrhoea and/or vomiting

Category 3

Appointment within 365 days is desirable

  • No category 3 criteria

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

  • Chronic diarrhoea is diarrhoea present for more than 3 weeks
  • Refer to HealthPathways for assessment and management information if available
  • If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: Department of Children, Youth Justice and Multicultural Affairs
  • Clinical urgency is the dominant consideration in the prioritisation of a referral for a child currently in out of home care (OOHC), or at risk of entering or leaving OOHC.

Referral requirements

A referral may be rejected without the following information.

History and Examination

  • Current height and weight and include date of measurement
  • History of diarrhoea – duration, frequency
  • Report presence or absence of concerning features for chronic diarrhoea
    • Blood or mucus
    • Nocturnal waking to stool
    • Urgency and incontinence
    • Weight loss
  • Does the child have abdominal pain? If so, report presence or absence of concerning features for abdominal pain
    • Recurrent waking from sleep with pain
    • Non-midline pain
    • Weight loss
    • Fevers
    • Blood or mucus mixed in stool
    • Waking at night to stool
  • Perianal inspection / fissures fistulae
  • Confirmation of OOHC (where appropriate)

Pathology and Test Results

  • Stool PCR for bacteria and parasites (if chronic diarrhoea present)
  • Faecal calprotectin

Additional referral information (useful for processing the referral)

Highly desirable information – may change triage category

  • If abdominal pain is present, history including frequency, duration and level of disruption (school missed, Emergency presentations, other history of distress)
  • History of vomiting – duration, frequency, hematemesis
  • Height/weight/head circumference and growth charts with prior measurements if available
  • Details of treatments offered and efficacy

Desirable information — will assist at consultation

  • Other past medical history
  • Immunisation history
  • Developmental history
  • Medication history
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Children, Youth Justice and Multicultural Affairs involvement)
  • Other physical examination findings inclusive of CNS, birth marks or dysmorphology
  • Any relevant laboratory results or medical imaging reports, urinalysis result

Investigations to consider if indicated (use clinical judgement)

  • FBC with differential. ESR U&E LFTs
  • Coeliac screen (aTTG) and total IgA level

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

Health pathways

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