Gastroenterology

Conditions

Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the out of scope section.

Paediatric services

Referrals for children and young people should follow the Children’s Health Queensland referral guidelines.

If any of the following are present or suspected arrange immediate transfer to the emergency department.

• Potentially life threatening symptoms suggestive of:
  • acute upper GI tract bleeding
  • acute severe lower GI tract bleeding
  • oesophageal foreign bodies/food bolus
  • acute severe colitis*
  • bowel obstruction
  • abdominal sepsis
• Severe vomiting and/or diarrhoea with dehydration
• Acute/fulminant liver failure (to be referred to a centre with dedicated hepatology services)
• Biliary sepsis (to be referred to a centre with ERCP service)

*Acute severe colitis as defined by the Truelove and Witts criteria – all patients with ≥ 6 bloody bowel motions per 24 hours plus at least one of the following:

• temperature at presentation of > 37.8°C
• pulse rate at presentation of > 90 bpm
• haemoglobin at presentation of < 105 gm/l, CRP >30mg/dl at presentation (or ESR > 30 mm/hr)

Out of scope services

Not all services are funded in the Queensland public health system. The following are not routinely provided in a public Gastroenterology outpatient service.

• Screening colonoscopy in asymptomatic patients outside of the NHMRC guidelines

If a patient has been fully investigated within 2 years of referral, the referrer and receiving clinician should exercise clinical decision-making in triaging and consider the value of repeat endoscopy / colonoscopy procedures.

Specialists list