Chronic and recurrent abdominal pain
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.
- Severe pain not able to be managed at home with simple analgesia
- Significant change in location or intensity of chronic abdominal pain suggestive of a new pathology
- Pain associated with vomiting where this has not occurred before
- Bile stained vomiting
- Inguinal hernia/testicular torsion
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
- Recurrent waking from sleep with abdominal pain
- Suspicion of serious gastrointestinal disease: persistent vomiting, weight loss or failure to thrive, dysphagia
- Extra-intestinal symptoms e.g. fever, rash, mouth ulcers, joint pain
- Blood or mucus in the stool
- Presence of anaemia or abnormalities of liver function tests
- Missing 50% or more of school or other history to suggest significant burden of symptomatology
- Children under 6 years with symptoms for more than 1 month at the time of referral
- 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 for chronic and recurrent abdominal pain
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
- 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 pain:
- how long has the child been experiencing recurrent abdominal pain?
- location of the abdominal pain
- Report presence or absence of concerning features
- Recurrent waking from sleep with pain.
- Non midline pain
- Weight loss
- Fevers
- Blood or mucus mixed in stool
- Waking at night to stool
- Clubbing
- Confirmation of OOHC (where appropriate)
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category.
- Detailed history of pain (including location, severity, onset and timing, aggravating and relieving factors and associated symptoms)
- Past history of abdominal surgery
- History of significant life disruption due to symptoms (emergency presentations, days of school missed in last month, other examples)
- Toileting history – stool frequency, consistency, pain, soiling, presence of blood
- Family history including of bowel diseases (crohns, ulcerative colitis, peptic ulcer or inflammatory bowel disease [IBD])
- Details of treatments offered and efficacy
- Abdominal examination findings / perianal inspection / inguinal herniae / testicular exam
- Height/weight/head circumference and growth charts with prior measurements if available.
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)
- FBE with differential ESR U&E LFTs, CRP
- Coeliac screen aTTG and total IgA level
- Iron studies
- Urinalysis
- Stool PCR for bacteria and parasites
- Abdominal USS, if clinically indicated
- Faecal calprotectin
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
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org