Gastroenterology Clinic

For health professionals

The Gastroenterology Clinic see patients with symptoms of the gastrointestinal tract. For example – reflux, PR bleeding.

Procedural information

We do not currently perform outpatient gastroenterology procedures.

Referrals to this service are assessed against the Statewide Referral Criteria. Please utilise HealthPathways to assist in making the referral. Referrals which do not meet the Statewide Referral Criteria will be declined.

Clinical information

• presenting problem and duration of symptoms
• GP diagnosis or provisional diagnosis, if known
• relevant medical history
• relevant social history or special needs
• current medications
• required investigation results
• allergies or warnings
• physical examination results
• management to date and response to treatment
• past surgery.

Investigations and results

Referral reason and required investigations (essential with referral)

Dyspepsia

• FBE; ESR; LFT’s +/- Amylase
• serological testing to confirm or rule out H.Pylori
• Barium swallow if appropriate
• previous scope reports (where available).

Weight Loss

• FBE; U&E’s; ESR; TFT’s; Creatinine; LFT’s; Fasting Glucose
• MSU
• previous scope reports (where available)
• CXR +/- CT Abdo/pelvis (where appropriate).

Vomiting and Nausea (>2 Weeks duration)

• FBE; U&E’s; ESR; Creatinine; LFT’s; Fasting Glucose
• MSU and Urine HCG
• previous scope reports (where available).

Non Acute Abdominal Pain – Upper

• FBE; U&E’s; LFT’s; Lipase; Iron Studies; Inflammatory markers
• H.Pylori Breath test
• MSU
• ECG
• abdominal ultrasound
• previous scope reports (where available).

Non Acute Abdominal Pain – Lower

• FBE; U&E’s; LFT’s; Lipase; Iron Studies; Inflammatory markers
• faecal MC&S
• MSU and Urine HCG
• results of PR examination
• abdominal ultrasound +/- pelvic ultrasound +/- abdominal CT
• previous scope reports (where available).

Altered Bowel Habits (with or without PR bleeding)

• FBE; CRP; iron studies
• coeliac serology if appropriate.

NOTE: if bloody diarrhoea and signs of dehydration are present refer to the emergency department

• faecal MC&S, Ova and Parasites, FOBT, CDT (Essential with referral)
• results of PR examination
• history of bowel habits and nature of the stool
• abdominal X-ray
• previous scope reports (where available).

Iron Deficiency Anaemia

• FBE; ESR, Iron Studies and Ferritin Levels
• previous scope reports (where available).

PR Bleeding

• FBE; CRP; Iron Studies
• PR examination findings
• previous scope reports (where available).

Liver and Hepatitis

• ANA; SMA; AMA.

NOTE: WMH does not have a liver specific clinic and the patient may be referred on as needed

• Ferritin and iron studies
• coeliac screen
• IgG; IgM
• serum lipids; Glucose
• abdominal ultrasound.

IBD

NOTE: WMH IBD clinic works in conjunction with the St Vincent’s IBD clinic. Patients requiring this service may be referred on.

• ANA; SMA; AMA.
• previous scope reports (where available)
• coeliac screen
• FBE; CRP.

Urgent (seen within 30 days of referral receipt)

The patient has a condition that has the potential to deteriorate quickly with significant consequences for health and quality of life if not managed promptly. Examples include:

• Positive FOBT – Refer to the Rapid Access Colonoscopy Clinic
• Strong suspicion of cancer
• Subacute GI bleeding/PR bleeding
• Severe Inflammatory Bowel Disease
• Altered bowel habit
• Iron deficiency anaemia
• Significant weight loss/anorexia/vomiting
• Abnormal liver function tests with associated jaundice

Non-urgent (seen within 365 days of referral receipt as clinically indicated)

The patient’s condition is unlikely to deteriorate quickly or have significant consequences for the person’s health and quality of life if specialist assessment is delayed beyond one month. Examples include:

• Constipation
• IBS
• Dyspepsia in the young with no alarm features
• Surveillance scopes
• Chronic abdominal pain
• Abnormal liver function tests

How to prepare the patient

Please advise your patient that it takes eight days to process a referral. On day eight a letter will be sent to them and the referrer advising of the referral outcome (either an appointment or allocation to the waiting list). For more information on what happens next, please refer to our understanding the referral process page.  If your patient’s condition changes before they see the specialist, they should either contact their GP or go to Emergency Department.

What/when you should refer to us

• You should refer to the Gastroenterology Clinic for conditions requiring a gastroenterologist’s opinion.
• For faecal occult blood test (FOBT) positive referrals, please confirm whether the result came from the National Bowel Cancer Screening Program.

Our clinic is receiving eReferrals via HealthLink SmartForms. Please see our Refer a patient page for more information.

What/when you should not refer to us

Do not refer:

• paediatric patients
• patients requiring a colonoscopy for a positive faecal occult blood test (FOBT). Please refer them to the Rapid Access Colonoscopy clinic.

If patients present with the following, refer to Emergency Department:

• acute melena
• hematemesis
• dysphagia with poor oral intake
• haematochezia
• bloody diarrhea with signs of dehydration.