Constipation with or without soiling
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
- The Prince Charles Hospital (07) 3139 4000
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 abdominal pain or vomiting with pain
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 less than 1 year
- Significant daily pain and distress in any child
- Weight loss
- Spinal, anal or lower limb abnormalities
- A child:
- at risk of entering the child protection system (0 – 18 years of age)
- currently in out of home care (OOHC) (0 – 18 years of age), or
- adolescents transitioning to adult healthcare following an out of home care experience (15 – 25 years of age)
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
- Children < 6 years who have not previously been diagnosed with chronic constipation and have not responded to adequate doses of laxatives
Category 3
Appointment within 365 days is desirable
- Children with long term (> 6 months) chronic constipation who have had previous specialist assessment
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 local HealthPathways or local guidelines
- Constipated infants < 12 months old should also be referred to child health nurse, community child health services
- Older children with constipation could also be referred to community child health services
- Include Bristol Stool Chart: Bristol Stool Chart
- Abdominal XR not required for referral and is almost always unnecessary
- In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
- 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.
- 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
Referral requirements
A referral may be rejected without the following information.
History and Examination
- Age at onset and duration of constipation
- Report presence or absence of concerning features
- Infant less than one year
- Severe recurrent abdominal pain
- Weight loss
- Physical examination, including abdominal examination, spine and lower limbs
- Confirmation of OOHC (where appropriate)
Additional referral information (useful for processing the referral)
Highly desirable information – may change triage category.
- History of abdominal pain including frequency, duration and level of disruption (school missed, emergency presentations)
- Toileting history – stool frequency, consistency, pain, frequency of soiling, presence of blood (Bristol Stool Chart)
- Infant feeding information– breast, formula, solids, dietary fluid/food intolerance
- Family history of bowel disorders
- History of behavioural or psychological disturbance
- Anal inspection for fissures/fistulae
- Past history of gastrointestinal disease e.g. necrotising enterocolitis, perianal disease
Desirable information- will assist at consultation
- Diet history
- Treatments used for constipation
- Stool withholding behaviour (apprehensive behaviour such as toilet refusal, hiding while defecation)
- Other past medical history
- Developmental history
- Immunisation history
- Medication history
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Child Safety, Seniors and Disability Services involvement)
- Height/weight/head circumference and growth charts with prior measurements if available.
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any relevant laboratory results or medical imaging reports, urinalysis result
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