Gastroenterology Clinic

The Gastroenterology Outpatients Clinic sees patients with general gastroenterological and liver conditions.

Referrals

Specific Clinic referral information :

  • Clinical details and reason for referral
  • Onset, characteristics and duration of symptoms
  • Relevant medical history
  • Dietary history
  • Results of all recent and relevant investigations
  • Medications(including non-prescription)
  • Alcohol use and injectable drug use
  • Allergies
  • Please include copies of any relevant test results to enable appropriate triaging
    (e.g. / Faecal occult blood test – National Bowel Cancer Screening Program).
  • Referrals with incomplete / insufficient information to enable triaging may be
    rejected until this information has been received.
    Please see statewide criteria link below:

Categories for appointment

Click to expand categories

Clinical DescriptionTimeframe
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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