The Gastroenterology Outpatients Service sees patients with general gastroenterological and liver conditions in a variety of clinics.
- Liver clinics
- Steatotic liver disease clinic for alcohol-related liver disease (with drug and alcohol services present) and non-alcoholic fatty liver disease
- Viral hepatitis service with a new nurse-led service
- Autoimmune liver disease clinic
- Hepatocellular carcinoma service – multidisciplinary with all treatments now offered locally
- Inflammatory Bowel Disease clinic including nurse led clinic and flare clinic
- Positive FOBT clinic
- Functional GI clinic
- Coeliac disease clinic
- Eosinophilic oesophagitis clinic
- Complex polyp removal service
Referrals
Referral addressed to named head of clinic is preferred.
The GP Referral Template located within the Mastercare Referralnet system is the preferred referral tool.
For faxed referrals: FAX 9125 9846
Categories for appointment
Click to expand categories
| Clinical Description | Timeframe | |
|---|---|---|
| Emergency | – Acute gastrointestinal tract haemorrhage (haematemesis and/or melaena and/or haematochezia – Bloody diarrhoea with signs of dehydration – Suspected acute, severe or fulminant hepatic failure – Severe hepatitis with jaundice – Symptomatic marked ascites or new onset of ascites – Suspected cholangitis – Moderate / severe pancreatitis | Go to Emergency Department |
| Category 1 Urgent | – Strong suspicion of cancer – Obstructive or unexplained cholestatic jaundice – Chronic GI bleeding o Iron deficiency anaemia o Occult GI bleeding (including positive FOBT) o Unexplained rectal bleeding – Severe inflammatory bowel disease – Suspected malabsorption, unexplained weight loss – Progressive or obstructive dysphagia – Decompensating liver disease, suspected chronic liver disease or moderate to severe abnormal LFTs Gastrointestinal symptoms (e.g. altered bowel habits, dyspepsia) with alarm/ red flag symptoms | < 30 Days |
| Category 2 Semi-Urgent | – Diarrhoea without alarm symptoms and normal investigations – Hepatitis B and C (active or untreated) – Haemochromatosis (untreated) New onset dyspepsia or reflux with no alarm symptoms (age ≥55) – Moderately elevated liver function tests – Stable inflammatory bowel disease – Previous polyps with high risk features (polyposis syndrome, previous endoscopic mucosal resection – Known Barrett’s oesophagus with dysplasia | > 3 months |
| Category 3 Routine | – Constipation – Abdominal Pain – Fatty liver with elevated liver function tests – Mild liver function test derangement – Family history of colon cancer (meeting NHMRC guidelines for screening) – Previous history of colonic polyps or Barrett’s oesophagus for surveillance – IBS management | Waitlist >12 -18 months |
Eligibility criteria
All adult residents within Peninsula Health geographical area.
Exclusions
Patients outside the geographically catchment area for Peninsula Health Children (<16 years old)
Indications for referral not meeting the state-wide referral criteria.
- Fatty liver with normal LFTs
- Constipation without alarm symptoms
- Positive coeliac gene test with normal coeliac serology
- Diarrhoea < 4 weeks without alarm symptoms (e.g. bleeding)
- Belching
- Halitosis
- Reflux (<55) where there are no alarm symptoms
- Non-iron deficiency in pre- menopausal women when menorrhagia
has been treated first - Isolated low serum iron
- PR bleed known to be coming from haemorrhoids or untreated anal
fissure
Alternative referral options
There can be a significant wait for new non-urgent patients to be seen in the clinic.
Please consider if the patient can be referred to the private rooms of specialists affiliated with Frankston Hospital (see Specialist Directory).
Make a referral
The following information is required for referral to this clinic.
- Abnormal LFT, suspected or follow up of cirrhosis.
Pathology Tests: LFT, FBE, INR, UEC, HBV serology, HCV serology
Imaging: Upper abdominal U/S, Hep B & C virus serology test, Fe studies.
Clinical History: Current medications, alcohol intake, injectable drug use. - Hepatitis B.
Pathology Tests: Hep B virus serology results (sAg/ Ab, eAg/ Ab, cAg/Ab), Hep B RNA PCR results, Hep C and HIV serology, LFT , FBE, previous liver biopsy results.
Imaging: Upper abdominal U/S.
Clinical History: Current medications. - Hepatitis C.
Pathology Tests: Hep C virus serology, HCV genotype and HVC RNA results, LFT, FBE, UEC, previous liver biopsy results.
Imaging: Upper abdominal U/S, liver fibrosis assessment (fibroscan or shearwave elastography).
Clinical History: current medications, alcohol history. - Persistent Iron deficiency +/-anaemia.
Pathology Results: FBE, iron studies (within one month of referral), coeliac serology, FOBT, faecal calprotectin.
Clinical History: Dietary history, mensural history, family history of GI diseases (IBD, cancers), current medications. - Rectal Bleeding.
Pathology Results: FBE, Iron studies, UEC.
Clinical History: Duration of symptoms, clinical characteristics (e.g. mixed with stool,
in toilet, on paper, pain), history of previous haemorrhoid treatment, family history
of gastrointestinal diseases and colorectal cancer, previous colonoscopy reports. - Unexplained weight loss or other sentinel symptoms (chronic nausea
and vomiting).
Pathology Results: FBE, EUC, LFT, ESR, CRP, fasting glucose, faecal calprotectin, FOBT results.
Imaging Results: Abdominal ultrasound, CT abdomen/ pelvis.
Clinical History: Duration of weight loss, amount of weight loss, associated symptoms, current medications. - Dysphagia.
Imaging: Barium swallow.(Please provide if available)
Clinical History: previous gastroscopy results. - Coeliac disease.
Pathology Results: Coeliac serology, FBE, Fe studies, Vitamin D, previous duodenal Biopsy Results if available. - Suspected Inflammatory Bowel disease.
Pathology Results: FBE, Iron Studies, CRP, faecal calprotectin, stool M/C/S + PCR, C
diff toxin.
Imaging Results: results of any abdominal imaging.
Clinical History: Duration of symptoms, bowel frequency, blood in stools, current medications, colonoscopy and histology results. - Chronic Diarrhoea.
Pathology Tests: FBE, UEC, CRP, EST, Fe studies, Faecal calprotectin, stool M/C/S and PCR. Stool Clostridium difficile toxin.
Clinical History: Frequency of bowel actions, duration of symptoms, current medications, previous colonoscopy results. - Irritable Bowel syndrome/ abdominal pain.
Pathology Results: FBE, UEC, LFT, CRP, coeliac serology, faecal calprotectin, stool M/C/S + PCR.
Imaging Results: plain abdominal x-ray.
Clinical History: Characteristics and durations of symptoms, dietary history, current medications. - Constipation.
Pathology Tests: FBE, Fe studies, UEC, calcium, TSH, Faecal occult blood test.
Clinical History: Duration of symptoms, current medications, documentation of failure to trials of standard laxatives. - Gastroesophageal reflux/ Epigastric pain, Dyspepsia.
Pathology Results: Helicobacter breath test, FBE, Iron studies.
Clinical History: response to trial of reflux medications, response to Helicobacter eradication (if breath test is positive), associated symptoms (dysphagia, weight changes), current medications, previous gastroscopy reports. - Surveillance of colorectal polyps, colorectal cancer or Barrett’s oesophagus.
Clinical History: Previous endoscopy report and histology (if not performed at Peninsula Health), any relevant gastrointestinal symptoms, current medications.
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