FAQs for General Practitioners

IBD – FAQs for General Practitioners

How do I make a referral to Monash Health IBD service?

A referral addressed to the Director of Gastroenterology, A/Prof. Sally Bell, can be sent to Monash Health in a number of ways: for referral templates, information on eReferrals and contact details, please see the Monash Health GP referrals page.

Where do I find the referral form to refer my patient to the Monash Health IBD service?

Monash Specialist Consulting now offers electronic referrals for an extensive range of Adult and Paediatric medical and surgical specialist clinics via HealthLink secure messaging.

GP practices that are HealthLink enabled can now send Monash Health eReferrals at no cost. This is the preferred means of making a referral.

eReferral resources can be found here.

A referral template can be downloaded from the referral templates and guides page.

What sort of patients can I refer to the Monash Health IBD service?

Patients with known IBD (for example, Crohn’s disease, ulcerative colitis, microscopic colitis, indeterminate colitis) or symptoms of undiagnosed IBD such as: recurrent perianal fistulas or abscesses, imaging results that strongly suggest Crohn’s disease or colitis, endoscopy findings consistent with inflammatory bowel disease.

Patients with the following conditions should be directed to the emergency department:

Acute severe colitis: patients with ≥ 6 bloody bowel motions per 24 hours plus at least one of the following:
- temperature > 37.8°C
- pulse rate > 90 bpm
- haemoglobin < 105 gm/L
- raised inflammatory markers (erythrocyte sedimentation rate (ESR) > 30 mm/hr or C-reactive protein (CRP) > 30 mg/L)
Suspected or known Crohn’s disease with acute complications:
- bowel obstruction
- sepsis or intra-abdominal or pelvic abscess.

What information needs to be included in the referral to Monash Health IBD service?

The more information you provide on your referral, especially your patient’s past medical history, up to date medications and appropriate investigations, the easier it is to make an appropriate assessment of your patient at the initial consultation.

This avoids delays and unnecessary additional clinic appointments.

Guidelines on what information to include in a referral to the gastroenterology department can be found here.

What initial work up should my patient have had prior to their consultation?

Please review the guidelines for referral to determine what initial work-up is required for the referral of patients with confirmed or suspected IBD.

It is usually appropriate to provide:

Comprehensive history of symptoms.
Stool studies, including microscopy, culture, sensitivities, Clostridiodes difficile toxin, faecal calprotectin.
Current and previous colonoscopy results if available.
Current and previous imaging results.
Inflammatory marker result (erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)).
Full blood examination.
Current and complete medication history (including non-prescription medicines, herbs and supplements).

What if I need a patient to be seen urgently?

If your patient needs an urgent review please make this clear on the referral.

If you would like to discuss a complex or urgent referral contact the gastroenterology registrar via Monash switchboard on (03) 9594 6666.

I have made a referral to Monash IBD Clinic but my patient has not received an appointment. Who can I contact to ensure my referral was received?

You can call the General Enquires number on 1300 342 273

Why was my referral rejected?

If the mandatory referral content was not included in your referral, it may be rejected.

Please included the information required and re-refer your patient to our service.

What happens if my patient has failed to attend their clinic appointment?

If your patient has failed to attend one appointment, they will receive another appointment at a time frame decided by one of our doctors.

If your patient fails to attend two appointments in a row, they may be discharged from the clinic and will need to be referred back to us.

A letter will be sent to notify you if this occurs.

My patient is seen at IBD clinic – what is my role in their care?

Patients with IBD may have extra requirements for primary care.

Management is shared between general practitioners and IBD clinicians.

Areas of importance are:

early diagnosis
psychological support
ensuring vaccinations are up to date; for many patients, immunosuppression increases the risk of infection. For some patients, live vaccines may be contraindicated
malignancy screening: this may include ensuring patients have appropriate skin checks, pap tests, colonoscopies
cardiovascular risk factor screening: patients with IBD are at higher cardiovascular risk
monitoring for disease activity
managing medication side effects and conducting regular medication reviews
bone health
management of IBD and medications during family planning, pregnancy and breastfeeding
smoking cessation
nutritional assessment and support